The next wave of hepatitis C virus: The epidemic of intravenous drug use

Abstract

The epidemic of hepatitis C virus (HCV) began in the 1960s when transmission was primarily the result of blood transfusions. By 1990, when HCV was identified and a serologic test for screening donated blood was implemented, 123 million persons had already become infected worldwide and HCV was the most common cause of cirrhosis, hepatocellular carcinoma and the most common indication for liver transplantation. Approximately 75% of persons with HCV are “baby boomers” born between the years 1945 and 1965. The number of new cases of HCV declined precipitously between 1990 and 2005. The next wave of HCV began in 2005, and transmission is primarily the result of an epidemic of intravenous drug use. New cases of HCV have increased three‐fold between 2005 and 2015. Approximately 50% of persons who inject drugs (PWID) have been exposed to HCV, and 25% of these persons are under the age of 25 years. The treatment of chronic HCV in PWID has two goals; treating HCV and preventing the patient from returning to drug use and becoming reinfected. Highly effective oral antiviral agents are now available and can cure HCV in virtually all patients. Treatment can be highly effective in PWID with sustained virologic response rates similar to that observed in a non‐drug‐using population. Preventing the patient from returning to drug use and becoming reinfected with HCV is more difficult and will require that the medical and social problems associated with intravenous drug use be addressed and resolved.

 

KEYWORDS
chronic HCV, HCV treatment, persons who inject drugs

 

About Speaker

Mitchell SHIFFMAN

Director Liver Institute of Virginia

USA

City: Richmond

Institution: Liver Institute of Virginia

Contact: Mitchell_Shiffman@bshsi.org


Biography of Mitchell SHIFFMAN

Dr Mitchell L Shiffman is the Director of the Liver Institute of Virginia at the Bon Secours Virginia Health System with offices in Richmond and Newport News, Virginia. He is also a Clinical Professor Medicine at the Eastern Virginia Medical School in Norfolk, Virginia. Dr Shiffman received his MD degree from the State University of New York Upstate Medical Center in Syracuse, completed residency and fellowship training in Internal Medicine, Gastroenterology and Hepatology at the Virginia Commonwealth University-Medical College of Virginia. He was the Chief of the Hepatology Section and Medical Director of the Liver Transplant Program at the VCU Medical Center in Richmond, Virginia between 1990-2009. Dr Shiffman has published over 275 articles in peer reviewed medical journals invited reviews and/or book chapters and has edited 3 textbooks on liver disease. He has organized and co-chaired 2 NIH development conferences. He has participated in clinical research studies for many different liver disorders although the majority of his writings and clinical research have focused on viral hepatitis C.

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