Publications & Reports

Barriers to receiving hepatitis C treatment for people who inject drugs: Myths and evidence.

Higgs P, Sacks-Davis R, Gold J, Hellard M
National Center in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia.


Background: Alcohol consumption, current injecting drug use, and pre-existing mental illness have been identified as 3 of the main reasons for excluding patients from treatment for hepatitis C.

Objectives: We reviewed the literature to obtain an evidence base for these common exclusion criteria.

Materials and methods: We reviewed original research and meta-analyses investigating the effects of alcohol consumption, current injecting drug use, and pre-existing mental illness.

Results: We identified 66 study reports relevant to the review, but found only limited evidence to support withholding of treatment on the basis of the 3 previously mentioned exclusion criteria.

Conclusions: Currently, there is a lack of evidence for many of the barriers faced by patients in availing treatment for hepatitis C. Adherence to treat routine was found to be a better predictor of sustained virological response than injecting drug or alcohol consumption during treatment period or the presence of a pre-existing mental disorder. Although several challenges remain, we need to ensure that treatment decisions are based on the best available evidence and the treatment is performed appropriately on a case-by-case basis.


  • Journal: Hepatitis Monthly
  • Published: 01/07/2011
  • Volume: 11
  • Issue: 7
  • Pagination: 513-518