Drug Use and Hepatitis C

The prevalence of hepatitis C among injecting drug users in EECA is among the highest in the world. However, this is matched by extremely low levels of treatment access, which means that people continue to die of cirrhosis of the liver and liver cancer.

With prevalence as high at 90 - 96% in some countries in the region, Eurasia has some of the highest rates of hepatitis C among people who use drugs (PWUD) in the world. Hepatitis C remains a treatable and in many cases a curable disease. However, only a few of those in need can get treatment and many people continue to die unnecessarily. The extremely high price of pegylated interferon, the key component in the recommended hepatitis C treatment, is the major barrier to accessing treatment. The average cost of 48-week course of treatment in EECA is US $15,000 and this makes it unaffordable for both individual patients and for governments. Only very few countries fund hepatitis C treatment through their domestic budgets but even in these cases people who use drugs are not a priority group for such treatment. The extremely limited availability of hepatitis treatment across EECA is one of the key reasons that HCV rates remain so high.

Inclusion criteria often exclude active injectors or PWUD, even though the exclusion of PWUD from hepatitis treatment contradicts internationally recognized protocols. This approach also impacts research into hepatitis C treatment, with PWUD again being excluded from clinical trials. As a result, there is a lack of research into hepatitis C treatment efficiency among PWUD and key issues such as treatment interactions between OST and HIV and TB treatment are not explored. This makes it much harder to define what is the most suitable treatment regimen for PWUD: such definition would help to increase the numbers of PWUD in hepatitis C treatment programs.

EHRN calls on harm reduction services and drug user groups to advocate for domestic funding for affordable, high-quality hepatitis C treatment on international, regional and national levels, and to start a dialogue with governments, international organizations, and pharmaceutical companies. A central demand is the call for the reduction of hepatitis C treatment costs to an affordable $2,000 for the 48-week treatment. At the same time, EHRN encourages its partners to continue pressing for pharmaceutical companies to expand clinical trials in EECA and to ensure that PWUD are properly included in such trials.

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Decrease in hepatitis C treatment costs after three years of activism among people living with hepatitis C in Georgia.

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