Toward Optimal Control of Hepatitis C Virus Infection in Persons With Substance Use Disorders
Authors: Andrew H. Talal, Dave L. Thomas, Jessica L. Reynolds, Jag H. Khalsa
Journal: Annals of Internal Medicine (2017)

Ideas and Opinions20 June 2017Toward Optimal Control of Hepatitis C Virus Infection in Persons With Substance Use DisordersAndrew H. Talal, MD, MPH, Dave L. Thomas, MD, Jessica L. Reynolds, PhD, and Jag H. Khalsa, MS, PhDAndrew H. Talal, MD, MPHFrom the University at Buffalo, The State University of New York, Buffalo, New York; Johns Hopkins University School of Medicine, Baltimore, Maryland; and the National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland., Dave L. Thomas, MDFrom the University at Buffalo, The State University of New York, Buffalo, New York; Johns Hopkins University School of Medicine, Baltimore, Maryland; and the National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland., Jessica L. Reynolds, PhDFrom the University at Buffalo, The State University of New York, Buffalo, New York; Johns Hopkins University School of Medicine, Baltimore, Maryland; and the National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland., and Jag H. Khalsa, MS, PhDFrom the University at Buffalo, The State University of New York, Buffalo, New York; Johns Hopkins University School of Medicine, Baltimore, Maryland; and the National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-2887 Annals Author Insight Video - Andrew H. Talal, MD, MPH In this video, Andrew H. Talal, MD, MPH, offers additional insight into the article, "Toward Optimal Control of Hepatitis C Virus Infection in Persons With Substance Use Disorders." SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The development of direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection has revolutionized treatment of this condition and may lead to its elimination. Crucial to this objective is eradication from persons with substance use disorders (SUDs), who account for 68% to 80% of infections in developed countries (1). The HCV treatment cascade has failed to achieve high rates of viral eradication among this population for many reasons, including stigmatization of an HCV diagnosis; discomfort encountered at conventional health care settings; chaotic lifestyles; lack of HCV-related knowledge; and multiple comorbidities, including HIV, hepatitis B virus (HBV) infection, and polysubstance addiction. ...References1. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis. 2005;5:558-67. [PMID: 16122679] CrossrefMedlineGoogle Scholar2. Gonzalez SA, Fierer DS, Talal AH. Medical and behavioral approaches to engage people who inject drugs into care for hepatitis C virus infection. Addict Disord Their Treat. 2017;16:S1-23. doi:10.1097/ADT.0000000000000104 CrossrefMedlineGoogle Scholar3. Martin NK, Vickerman P, Grebely J, Hellard M, Hutchinson SJ, Lima VD, et al. Hepatitis C virus treatment for prevention among people who inject drugs: modeling treatment scale-up in the age of direct-acting antivirals. Hepatology. 2013;58:1598-609. [PMID: 23553643] doi:10.1002/hep.26431 CrossrefMedlineGoogle Scholar4. Martinez AD, Dimova R, Marks KM, Beeder AB, Zeremski M, Kreek MJ, et al. Integrated internist–addiction medicine–hepatology model for hepatitis C management for individuals on methadone maintenance. J Viral Hepat. 2012;19:47-54. [PMID: 21129131] doi:10.1111/j.1365-2893.2010.01411.x CrossrefMedlineGoogle Scholar5. Bruggmann P, Litwin AH. Models of care for the management of hepatitis C virus among people who inject drugs: one size does not fit all. Clin Infect Dis. 2013;57 Suppl 2:S56-61. [PMID: 23884067] doi:10.1093/cid/cit271 CrossrefMedlineGoogle Scholar6. Dimova RB, Zeremski M, Jacobson IM, Hagan H, Des Jarlais DC, Talal AH. Determinants of hepatitis C virus treatment completion and efficacy in drug users assessed by meta-analysis. Clin Infect Dis. 2013;56:806-16. [PMID: 23223596] doi:10.1093/cid/cis1007 CrossrefMedlineGoogle Scholar7. Dore GJ, Altice F, Litwin AH, Dalgard O, Gane EJ, Shibolet O, et al; C-EDGE CO-STAR Study Group. Elbasvir–grazoprevir to treat hepatitis C virus infection in persons receiving opioid agonist therapy. A randomized trial. Ann Intern Med. 2016;165:625-34. [PMID: 27537841]. doi:10.7326/M16-0816 LinkGoogle Scholar8. Grebely J, Dore GJ, Zeuzem S, Aspinall RJ, Fox R, Han L, et al. Efficacy and safety of sofosbuvir/velpatasvir in patients with chronic hepatitis C virus infection receiving opioid substitution therapy: analysis of phase 3 ASTRAL trials. Clin Infect Dis. 2016;63:1479-81. [PMID: 27553377] CrossrefMedlineGoogle Scholar9. Lalezari J, Sullivan JG, Varunok P, Galen E, Kowdley KV, Rustgi V, et al. Ombitasvir/paritaprevir/r and dasabuvir plus ribavirin in HCV genotype 1-infected patients on methadone or buprenorphine. J Hepatol. 2015;63:364-9. [PMID: 25839406] doi:10.1016/j.jhep.2015.03.029 CrossrefMedlineGoogle Scholar10. Grebely J, Mauss S, Brown A, Bronowicki JP, Puoti M, Wyles D, et al. Efficacy and safety of ledipasvir/sofosbuvir with and without ribavirin in patients with chronic HCV genotype 1 infection receiving opioid substitution therapy: analysis of phase 3 ION trials. Clin Infect Dis. 2016;63:1405-11. [PMID: 27553375] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the University at Buffalo, The State University of New York, Buffalo, New York; Johns Hopkins University School of Medicine, Baltimore, Maryland; and the National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.Disclaimer: The observations are those of the authors and do not necessarily reflect the views of the University at Buffalo, The State University of New York; Johns Hopkins University; the National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Services; or the Patient-Centered Outcomes Research Institute, its Board of Governors, or its Methodology Committee.Financial Support: By awards from the National Institutes of Health (4 P30 AI078498), from the Patient-Centered Outcomes Research Institute (IHS-1507-31640), and the Troup Fund of the Kaleida Health Foundation, to Dr. Talal.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-2887.Corresponding Author: Andrew H. Talal, MD, MPH, University at Buffalo, The State University of New York, Clinical and Translational Science Center, 875 Ellicott Street, Suite 6090, Buffalo, NY 14203; e-mail, [email protected]edu.Current Author Addresses: Dr. Talal: University at Buffalo, The State University of New York, Clinical and Translational Science Center, 875 Ellicott Street, Suite 6090, Buffalo, NY 14203.Dr. Thomas: Johns Hopkins University School of Medicine, Suite 437, 1830 Monument Street, Baltimore, MD 21205.Dr. Reynolds: University at Buffalo, The State University of New York, Clinical and Translational Science Center, 875 Ellicott Street, Suite 6075, Buffalo, NY 14203.Dr. Khalsa: National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Room 4137, Bethesda, MD 20892-9551.Author Contributions: Conception and design: A.H. Talal, J.L. Reynolds, D.L. Thomas, J.H. Khalsa.Drafting of the article: D.L. Thomas, A.H. Talal, J.L. Reynolds, J.H. Khalsa.Critical revision of the article for important intellectual content: A.H. Talal, D.L. Thomas, J.H. Khalsa, J.L. Reynolds.Final approval of the article: A.H. Talal, D.L. Thomas, J.L. Reynolds, J.H. Khalsa.Obtaining of funding: A.H. Talal.This article was published at Annals.org on 25 April 2017. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Andrew H. Talal, MD, MPH In this video, Andrew H. Talal, MD, MPH, offers additional insight into the article, "Toward Optimal Control of Hepatitis C Virus Infection in Persons With Substance Use Disorders." 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