Clinical trial: a primary-care-based model for the delivery of anti-viral treatment to injecting drug users infected with hepatitis C

Aliment Pharmacol Ther. 2009 Jan;29(1):38-45. doi: 10.1111/j.1365-2036.2008.03872.x. Epub 2008 Oct 13.


Background: Injecting drug use is the main risk factor for hepatitis C virus (HCV) infection. Secondary-care-based strategies for the management of HCV do not effectively target this vulnerable population.

Aims: To evaluate the feasibility, safety and efficacy of a primary-care-based model for the delivery of HCV services including anti-viral therapy to injecting drug users.

Methods: A partnership between a clinical nurse specialist employed by, and working under the supervision of, a secondary-care-based hepatitis service and drug workers and general practitioners. Three hundred and fifty-three clients attending opiate substitution clinics in primary care were evaluated. Outcomes were: number of new diagnoses of HCV infection, number of clients assessed as suitable for anti-viral treatment, and number of patients treated.

Results: 174 HCV antibody positive clients were identified. Of these, 124 were chronically infected with HCV of whom only six had been previously identified. Of 118 new chronically-infected individuals, 86 entered the care pathway, 43 were assessed as suitable for anti-viral treatment and 30 have so far been treated. Outcomes of anti-viral treatment are comparable with those obtained in secondary care settings.

Conclusion: A primary-care-based model offers a new paradigm for the treatment of HCV in injecting drug users.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Algorithms
  • Antiviral Agents / therapeutic use*
  • Cohort Studies
  • Drug Users
  • Female
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Nurse Clinicians
  • Opioid-Related Disorders / complications*
  • Patient Compliance
  • Primary Health Care*
  • Substance Abuse, Intravenous / complications*
  • Treatment Outcome
  • United Kingdom
  • Young Adult


  • Antiviral Agents