Jason Grebely, PhD; Gregory J. Dore, MBBS, PhD; Robert Greenwald, JD; Tracy Swan; Soumitri Barua; Lynn E. Taylor, MD
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).
Grebely J., Dore G., Greenwald R., Swan T., Barua S., Taylor L.; Hepatitis C Virus Treatment and Persons Who Inject Drugs. Ann Intern Med. 2016;164:203. doi: 10.7326/L15-0485
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Published: Ann Intern Med. 2016;164(3):203.
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 for persons with a history of injection drug use, those receiving OST, and those who have recently used injection drugs, with responses similar to those of populations who do not use drugs (3, 4). Recent injection drug use at treatment initiation and occasional drug use during treatment has limited effects on adherence, treatment completion, and response (3, 4).
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