Abstract
Inadequate hepatitis C virus (HCV) assessment and treatment among people who inject drugs (PWID) is a result of patient, provider and health system level barriers. Low HCV treatment rates continue even though guidelines have been revised to consider HCV treatment among PWID on a case-by-case basis. If accessibility to HCV treatment were increased, especially to PWID this would greatly decrease the pool of communicable disease. In order to successfully control and prevent HCV infection PWID must be actively engaged in the treatment process. Physicians’ attitudes towards HCV treatment can be represented in studies as views that are directly perceived by the physician or indirectly as perceived by the patient who is under the care of the physician. The current review focuses on examining both the indirect and direct views of physician’s attitudes in treating HCV-infected PWID and examines how this influences and impacts provision of HCV treatment. A review of the literature suggests that physician’s have varied attitudes towards their patients who use recreational drugs and who are HCV positive. Moreover it is the negative associations between HCV and drug use that can impact HCV treatment accessibility and affect the number of people who can actively begin treatment.
Highlights
130-150 million people are estimated to live with chronic hepatitis C virus (HCV) [1]
Physicians’ attitudes towards HCV treatment can be represented in studies as views that are directly perceived by the physician or indirectly as perceived by the patient who is under the care of the physician
Another study indicated that health professionals reported no increase in treatment discontinuation in current people who inject drugs (PWID), physicians indicated that is was important for their HCV infected patients to have careful pre-treatment assessments to ensure that they are appropriately prepared for treatment [43]
Summary
130-150 million people are estimated to live with chronic HCV [1]. HCV is most commonly transmitted through injection drug use and the sharing of injection equipment [1]. One study identified reasons why primary care physicians were not providing treatment to their HCV-infected patients. Another study indicated that health professionals reported no increase in treatment discontinuation in current PWIDs, physicians indicated that is was important for their HCV infected patients to have careful pre-treatment assessments to ensure that they are appropriately prepared for treatment [43]. A study from the US reported that only 9% of the surveyed addiction specialists would directly treat a PWID who is infected with HCV and that only an additional third were willing to provide HCV antiviral therapy if they received the appropriate education and training [32]. The relationship between a PWID with an HCV positive status and their physician greatly influences the type of medical care that he or she will receive Many of these individuals have experienced discrimination in the health care setting, which has interfered with initiating HCV therapy. When PWID with HCV have a trusting rapport with their physician, this increases the chances that treatment will be started and followed though successfully
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