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Hépato-Gastro & Oncologie Digestive

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Chronic hepatitis C among injection drug users Volume 24, issue 3, Mars 2017

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Authors
Centre Hospitalier Universitaire de Nancy,
Université de Lorraine,
Hôpital Brabois,
service d’hépato-gastro-entérologie,
rue du Morvan,
54550 Vandœuvre-lès-Nancy,
France
* Tirés à part

The prevalence of hepatitis C is high among injection drug users who have often significant social and psycho-social vulnerabilities making their management difficult. Increasing diagnostic testing and access to treatment are key factors of prevention. Improve training of actors in contact with drug users on the HCV risks is important to promote diagnostic testing, allow risk reduction actions and HCV knowledge. HCV testing can be performed in specialized centers in drug addiction; the interest of rapid tests of diagnostic orientation is evident as an alternative to venous sampling. The hepatology consultation must be advanced in the centers of addiction, and could promote a comprehensive, coordinated and multidisciplinary response, combining addiction specialist, hepatologist, general practitioner, psychiatrist, nurses and social workers. The sociomedical approach is essential in the management of DUs often in precarious situations. Currently, available treatments are as effective among drug users as in the general population; to promote earlier treatment of drug users is important to reduce the risk of transmission. Patient education promotes regular monitoring and better compliance. All these associated efforts should improve the effectiveness of prevention and risk reduction allowing HCV eradication in this population.