Hepatitis C Virus Treatment and Persons Who Inject Drugs
Authors: Jason Grebely, Gregory J. Dore, Robert Greenwald, Tracy Swan, Soumitri Barua, Lynn E. Taylor
Journal: Annals of Internal Medicine (2016)

Letters2 February 2016Hepatitis C Virus Treatment and Persons Who Inject DrugsJason Grebely, PhD, Gregory J. Dore, MBBS, PhD, Robert Greenwald, JD, Tracy Swan, Soumitri Barua, and Lynn E. Taylor, MDJason Grebely, PhDFrom The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts; Treatment Action Group, New York, New York; Brown University, Providence, Rhode Island; Brown University and Miriam Hospital, Providence, Rhode Island., Gregory J. Dore, MBBS, PhDFrom The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts; Treatment Action Group, New York, New York; Brown University, Providence, Rhode Island; Brown University and Miriam Hospital, Providence, Rhode Island., Robert Greenwald, JDFrom The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts; Treatment Action Group, New York, New York; Brown University, Providence, Rhode Island; Brown University and Miriam Hospital, Providence, Rhode Island., Tracy SwanFrom The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts; Treatment Action Group, New York, New York; Brown University, Providence, Rhode Island; Brown University and Miriam Hospital, Providence, Rhode Island., Soumitri BaruaFrom The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts; Treatment Action Group, New York, New York; Brown University, Providence, Rhode Island; Brown University and Miriam Hospital, Providence, Rhode Island., and Lynn E. Taylor, MDFrom The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts; Treatment Action Group, New York, New York; Brown University, Providence, Rhode Island; Brown University and Miriam Hospital, Providence, Rhode Island.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-0485 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We are alarmed by McCance-Katz and Valdiserri's statements that "the best outcomes occur in persons who have ceased injection and other drug use," Medicaid restrictions based on drug and alcohol criteria are "necessary due to the high cost of hepatitis C virus (HCV) treatment," and persons with a history of injection drug use should be advised to continue opioid-substitution therapy (OST) "indefinitely" (1). There is no rationale for establishing a salient difference between persons with HCV infection who do and do not use alcohol, drugs, or both (2). As international recommendations highlight (3), HCV treatment is effective ...References1. McCance-Katz EF, Valdiserri RO. Hepatitis C virus treatment and injection drug users: it is time to separate fact from fiction. Ann Intern Med. 2015;163:224-5. [PMID: 26120801]. doi:10.7326/M15-0007 LinkGoogle Scholar2. Grebely J, Haire B, Taylor LE, Macneill P, Litwin AH, Swan T, et al; International Network for Hepatitis in Substance Users. Excluding people who use drugs or alcohol from access to hepatitis C treatments—is this fair, given the available data? [Editorial]. J Hepatol. 2015;63:779-82. [PMID: 26254264] doi:10.1016/j.jhep.2015.06.014 CrossrefMedlineGoogle Scholar3. Grebely J, Robaeys G, Bruggmann P, Aghemo A, Backmund M, Bruneau J, et al; International Network for Hepatitis in Substance Users. Recommendations for the management of hepatitis C virus infection among people who inject drugs. Int J Drug Policy. 2015;26:1028-38. [PMID: 26282715] doi:10.1016/j.drugpo.2015.07.005 CrossrefMedlineGoogle Scholar4. Aspinall EJ, Corson S, Doyle JS, Grebely J, Hutchinson SJ, Dore GJ, et al. Treatment of hepatitis C virus infection among people who are actively injecting drugs: a systematic review and meta-analysis. Clin Infect Dis. 2013;57 Suppl 2:S80-9. [PMID: 23884071] doi:10.1093/cid/cit306 CrossrefMedlineGoogle Scholar5. Barua S, Greenwald R, Grebely J, Dore GJ, Swan T, Taylor LE. Restrictions for Medicaid reimbursement of sofosbuvir for the treatment of hepatitis C virus infection in the United States. Ann Intern Med. 2015;163:215-23. [PMID: 26120969]. doi:10.7326/M15-0406 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts; Treatment Action Group, New York, New York; Brown University, Providence, Rhode Island; Brown University and Miriam Hospital, Providence, Rhode Island.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0485.Financial Support: The Kirby Institute is funded by the Australian Government Department of Health and Ageing. Dr. Grebely is supported by a National Health and Medical Research Council Career Development Fellowship. Mr. Greenwald is supported by Harvard Law School. Dr. Taylor is supported by a Rhode Island Innovation Fellowship from the Rhode Island Foundation for her Rhode Island Defeats Hep C project and the Lifespan/Tufts/Brown Center for AIDS Research (grant P30AI042853 from the National Institute of Allergy and Infectious Diseases). Ms. Barua was supported by the Lifespan/Tufts/Brown Center for AIDS Research Summer Student Internship program (grant P30AI042853). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHepatitis C Virus Treatment and Injection Drug Users: It Is Time to Separate Fact From Fiction Elinore F. McCance-Katz and Ronald O. Valdiserri Hepatitis C Virus Treatment and Persons Who Inject Drugs Elinore F. McCance-Katz and Ronald O. Valdiserri Metrics Cited byLymphocyte Landscape after Chronic Hepatitis C Virus (HCV) Cure: The New NormalElimination of hepatitis C virus has limited impact on the functional and mitochondrial impairment of HCV-specific CD8+ T cell responsesHepatitis C Testing, Status and Treatment among Marginalized People Who Use Drugs in an Inner City Setting: An Observational Cohort StudyAmerican Gastroenterological Association Institute Clinical Practice Update—Expert Review: Care of Patients Who Have Achieved a Sustained Virologic Response After Antiviral Therapy for Chronic Hepatitis C InfectionSecond generation direct-acting antivirals – Do we expect major improvements? 2 February 2016Volume 164, Issue 3Page: 203KeywordsAlcoholsCareers in researchDisclosureDrug adherenceDrug therapyDrugsFellowshipsHepatitis C virusPopulation statisticsPrevention, policy, and public health ePublished: 2 February 2016 Issue Published: 2 February 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. 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