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Are we ready to treat hepatitis C virus in individuals with opioid use disorder: assessment of readiness in European countries on the basis of an expert-generated model

Wright, Nata; Reimer, Jensd; Somaini, Lorenzoe; Roncero, Carlosj; Maremmani, Icrof; Simon, Nicolasi; Krajci, Peterk; Littlewood, Richardb; D’Agnone, Oscarc; Alho, Hannul; Rolland, Benjaming,h

European Journal of Gastroenterology & Hepatology: November 2017 - Volume 29 - Issue 11 - p 1206–1214
doi: 10.1097/MEG.0000000000000962
Review Articles

Individuals with a history of injecting drugs have a high prevalence of chronic hepatitis C (HCV) infection. Many have a history of opioid use disorder (OUD). Despite novel treatments with improved efficacy and tolerability, treatment is limited in the group. A faculty of experts shared insights from clinical practice to develop an HCV care-readiness model. Evidence and expert knowledge was collected. Ten experts developed a model of three factors (with measures): ‘healthcare engagement’, ‘guidance’ and ‘place’. Overall, 40–90% of individuals with OUD engage with drug treatment services. Ten of 12 HCV guidelines provided specific advice for the OUD population. Ten of 12 OUD care guidelines provided useful HCV care advice. In 11 of 12 cases, location of HCV/drug treatment care was in different places. This readiness assessment shows that there are important limitations to successful HCV care in OUD. Specific actions should be taken: maintain/increase access to OUD treatment services/opioid agonist therapy, updating HCV guidance, locate care in the same place and allow wider prescribing of anti HCV medicines.

aTransform Research Alliance, Huddersfield University, Huddersfield

bApplied Strategic, London

cFaculty of Medical and Human Sciences, Institute of Brain Behaviour and Mental Health, Manchester, UK

dDepartment of Psychiatry and Psychotherapy, Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

eAddiction Treatment Centre, Biella

fDepartment of Psychiatry, Santa Chiara University Hospital, University of Pisa, Italy

gDepartment of Addiction Medicine, University Hospital of Lille, Lille

hPharmacology, University Hospital of Lille, Lille

iDepartment of Adult Psychiatry and Clinical Pharmacology, Public Assistance Marseillie Hospital, Sainte Marguerite Hospital, Marseille, France

jDepartment of Psychiatry, Addiction and Dual Diagnosis Unit, Vall d’Hebron University Hospital, Biomedical Research Center Network of Mental Health, Autonomous University of Barcelona, Barcelona, Spain

kDepartment of Substance Use Disorder Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway

lAbdominal Center, Department of Medicine, University Hospital and University of Helsinki, Helsinki, Finland

Correspondence to Nat Wright, FRCGP, PhD, Spectrum Community Health CIC, One Navigation Walk, Hebble Wharf, Wakefield WF1 5RH, UK Tel: +44 192 431 1400; fax: +44 192 467 5360; e-mail: natwright@nhs.net

Received May 31, 2017

Accepted July 25, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.