HCV treatment: more effective medications
As HCV infection is highly prevalent among people who inject drugs in Europe, they are a key target for testing and treatment, in order to prevent liver disease progression and deaths. Moreover, reducing the number of people who can transmit the infection, by offering HCV treatment, is an essential component of a comprehensive prevention response. European clinical guidelines recommend that all patients with chronic liver disease due to HCV infection must be considered for therapy. The guidelines also recommend that treatment should be considered without delay in individuals at risk of transmitting the virus (including active injecting drug users) and that HCV treatment should be provided to drug users on an individualised basis and delivered in a multidisciplinary setting.
Since 2013, effective, better tolerated, all-oral, interferonfree regimens with direct-acting antiviral agents are becoming the mainstay of the treatment of HCV infection. Furthermore, treatment with these medicines may be offered in specialised drug services in community settings, which may increase uptake and availability. Many European countries are adopting new viral hepatitis strategies, updating treatment guidelines and improving HCV testing and linkage to care. However, challenges remain, such as low levels of testing, unclear referral and treatment pathways in many countries, and the high cost of the new drugs.
Drug use is a recognised cause of avoidable mortality among European adults