Optimizing assessment and treatment for hepatitis C virus infection in illicit drug users: a novel model incorporating multidisciplinary care and peer support

Eur J Gastroenterol Hepatol. 2010 Mar;22(3):270-7. doi: 10.1097/meg.0b013e32832a8c4c.


Objectives: We evaluated assessment and treatment for hepatitis C virus (HCV) among illicit drug users accepting referral to a weekly HCV peer-support group at a multidisciplinary community health centre.

Methods: From March 2005 to 2008, HCV-infected individuals were referred to a weekly peer-support group and assessed for HCV infection. A retrospective chart review of outcomes 3 years after the initiation of the group was conducted (including HCV assessment and treatment).

Results: Two hundred and four HCV antibody-positive illicit drug users accepted referral to a weekly HCV peer-support group. Assessment for HCV occurred in 53% of patients(n= 109), with 13% (n= 14) having initiated or completed treatment for HCV infection before attending the support group, evaluation ongoing in 10% (n= 11) and treatment deferred/not indicated in 25% (n= 27). The major reasons for HCV treatment deferral included early disease (30%),drug dependence (37%), other medical (11%) or psychiatric comorbidities (4%). Sixty-eight percent of those deferred for reasons other than early liver disease showed multiple reasons for treatment deferral. The first 4 weeks of support group attendance predicted successful HCV assessment (odds ratio: 6.03, 95% confidence interval:3.27-11.12, P < 0.001). Overall, 28% (n= 57) received treatment. Among individuals having completed pegylated-interferon and ribavirin therapy with appropriate follow-up (n =19), the rate of sustained virologic response was 63% (12/19), despite illicit drug use in 53%.

Conclusion: A high proportion of illicit drug users accepting referral to a weekly HCV peer-support group at a multidisciplinary health centre were assessed and treated for HCV infection. Peer support coupled with multidisciplinary care is an effective strategy for engaging illicit drug users in HCV care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Drug Carriers
  • Female
  • Hepatitis C / diagnosis*
  • Hepatitis C / drug therapy*
  • Hepatitis C / etiology
  • Hepatitis C / immunology
  • Hepatitis C Antibodies / blood
  • Humans
  • Interdisciplinary Communication*
  • Interferons / therapeutic use
  • Male
  • Medical Records
  • Middle Aged
  • Odds Ratio
  • Patient Care Team*
  • Peer Group*
  • Polyethylene Glycols
  • Retrospective Studies
  • Ribavirin / therapeutic use
  • Self-Help Groups*
  • Substance-Related Disorders / complications*
  • Treatment Outcome


  • Antiviral Agents
  • Drug Carriers
  • Hepatitis C Antibodies
  • Polyethylene Glycols
  • Ribavirin
  • Interferons