Substance use disorders affect roughly 25% of Americans aged 12 and older, with illicit drug use prevalent in 2022. The advent of direct-acting antivirals (DAAs) has transformed hepatitis C virus (HCV) treatment, allowing individuals with active or recent substance use to receive care without the prerequisite of abstinence. The complex relationship between substance use and HCV continues to affect both disease management and access to treatment, highlighting the need for comprehensive guidelines that accommodate the nuances of treating HCV in those with substance use disorders.

HCV treatment guidelines now advocate for universal treatment accessibility for all with chronic HCV, except in cases of extremely limited life expectancy. These guidelines also dismiss the necessity for abstinence from drugs or alcohol prior to treatment, recognizing that such requirements do not impact the effectiveness of DAAs, even among those with opioid use disorder undergoing opioid agonist therapy. This inclusive approach not only facilitates the management of HCV but also serves as a preventive strategy by potentially curbing the virus’s spread among high-risk groups, such as people who inject drugs.

Reference: Corcorran M, Spach D. Treatment of HCV in Persons with Substance Use. Hepatitis C Online. Updated January 25th, 2024. Accessed June 5, 2024. https://www.hepatitisc.uw.edu/go/key-populations-situations/treatment-substance-use/core-concept/all