Barriers and facilitators to hepatitis C treatment for people who inject drugs. A qualitative study

2012 Hepatitis C virus (HCV) infection is a significant global public health problem. The burden of HCV infection is concentrated among people who inject drugs (PWID), with an estimated five million PWID living with chronic HCV in the European Region. HCV antiviral treatment with peginterferon alfa and ribavirin is the standard care for chronic HCV, with a 50-85% cure rate depending on genotype. Research indicates that PWID are interested in HCV treatment uptake and have rates of viral clearance comparable with other populations. Current injectors are not precluded from HCV treatment access in a number of European countries, yet uptake rates are substandard.

This qualitative study aims to assess the barriers and facilitators to HCV treatment access and completion for PWID in drug and alcohol (D&A) settings. We examine the barriers and facilitators to HCV treatment by: describing pathways to hepatitis C treatment, including referral, as well as factors mediating treatment access in the D&A setting. Through qualitative interviews with HCV treatment providers and PWID we explore the experience of HCV treatment access and delivery from patient, provider and ‘system’ perspectives in order to develop guidance regarding HCV treatment system improvement, including referral and coordination, and the provision of psycho-social interventions targeting patients and providers.