Evaluation of a Multi-disciplinary Approach for the Treatment of Hepatitis C in IDUs (HI-LO Study)
Status:
Completed
Trial end date:
2012-12-01
Target enrollment:
Participant gender:
Summary
Although injection drug users (IDUs) account for over 70% of new cases of HCV infection/year,
there is no consensus on how to approach their medical care. In some Canadian centres,
patients must be free of recreational drug use for as long as 6 months before being
considered for HCV therapy. This is not consistent with current North American guidelines.
Over the past 5 years, we have developed a successful program for the treatment of HIV
infection in this population, based on a multi-disciplinary comprehensive program including
directly observed therapy (DOT). Even though the duration of therapy for HCV is shorter than
for HIV (as little as 6 months vs. life-long), we must address issues of administration of a
weekly injection (interferon), twice daily pills (ribavirin) and the risk of significant side
effects (including anxiety and depression) to successfully expand our program to treat this
disease. Further, it may be that even if the program is successful, its benefits will be
negated by HCV re-infection due to continued risk behaviors for its transmission.