Guidelines for the treatment of hepatitis C virus infection in injection drug users: status quo in the European Union countries.

Summary 
Treatment guidelines are considered to be an important tool in steering patients to medical treatment. This study was conducted to analyze guidelines for the treatment of hepatitis C virus (HCV) infection in injection drug users (IDUs) in the European Union (EU) countries as a component of treatment access. National and international databases, expert contacts, professional societies, and health administrations were approached to acquire guidelines. According to their quality standard, guidelines were divided into expert opinions, semiofficial guidelines, official guidelines, and consensus processes. Recommendations for the treatment of HCV infection in IDUs vary substantially, from lack of recommendations and outright treatment disapproval to recommendations for treatment under specified circumstances. Recent guidelines that apply qualified process procedures that include literature research tend to be more permissive. Qualified guideline processes in each EU country and subsequently renewed pan-European guidelines are needed. Please see additional information below for the context of this study.

PDF download

PDF files are made available as a convenience. In cases where the EMCDDA is not the originator of the document, please be aware that any PDFs available on this page may not be authoratative or there may be more recent versions available. While we make every effort to ensure that these files are definitive, before using or citing them, we recommend that you consult the publisher's website or contact the author(s) to check for more recent versions.

40-Supplement_5-S373.pdf
multilingual

Abstract

This abstract is provided here as a convenience only. Check the publisher's website (if available) for the definitive version.

Treatment guidelines are considered to be an important tool in steering patients to medical treatment. This study was conducted to analyze guidelines for the treatment of hepatitis C virus (HCV) infection in injection drug users (IDUs) in the European Union (EU) countries as a component of treatment access. National and international databases, expert contacts, professional societies, and health administrations were approached to acquire guidelines. According to their quality standard, guidelines were divided into expert opinions, semiofficial guidelines, official guidelines, and consensus processes. Recommendations for the treatment of HCV infection in IDUs vary substantially, from lack of recommendations and outright treatment disapproval to recommendations for treatment under specified circumstances. Recent guidelines that apply qualified process procedures that include literature research tend to be more permissive. Qualified guideline processes in each EU country and subsequently renewed pan-European guidelines are needed.

Additional information 

This study was funded through an EMCDDA contract (CT.2003.104.P2).

In 2003, the EMCDDA launched a consultant study to determine if treatment guidelines in use across 15 EU countries and Norway limit or promote the access of injecting drug users to treatment for liver disease. The four specific objectives of this study were: 

  • To identify and compile official and semi-official guidelines for the treatment of hepatitis C infection in drug users that are in use in EU Member States and Norway; 
  • To compare the guidelines and identify similarities, differences, and consistency with the state of research;
  • To critically assess their potential with regard to enabling access to treatment of hepatitis C infection in drug users, especially active drug users and those that are HIV co-infected;
  • To identify possible needs with regard to increased treatment access.

The consultant expert group (http://www.zis-hamburg.de/index.en.html) established contact with the National Reitox focal points, professional societies and experts throughout Europe and gathered treatment consensus statements, official and semi-official guidelines as well as expert opinions. Several quality and contents aspects of the treatment recommendations were appraised, applying a standardised qualitative evaluation tool for the assessment of the guidance.. The analysis includes an assessment of scientific rigour and evidence base, clarity and applicability of the treatment guidelines and as well as of their editorial independence. 

The study, completed in 2004, showed that recommendations for the treatment of HCV in IDUs vary substantially, from a lack of recommendations and outright treatment disapproval to recommendations for treatment under specified circumstances. Recent guidelines that apply qualified process procedures and include literature research tend to be more permissive (see also Reimer J et al. (2005) Guidelines for the treatment of hepatitis C virus infection in injection drug users: status quo in the European Union countries. Clin Infect Dis., Vol 40 (15 April), Supplement 5, S 373-378.)

article thumbnail
Date 15 April 2005
Access
Open access
Publisher 
Oxford Academic
Geographical scope
Austria
Belgium
Denmark
EU/Europe
FInland
France
Germany
Italy
Netherlands
Norway
Spain
Sweden
United Kingdom
Journal 
Clinical Infectious Diseases
Volume 40, Issue Supplement_5, April 2005, Pages S373–S378
Authors 
Jens Reimer,1 Bernd Schulte, Xavier Castells, Ingo Schafer, Susanne Polywka, Dagmar Hedrich, Lucas Wiessing, Christian Haasen, Markus Backmund,2 and Michael Krausz
Publisher's DOI:
https://doi.org/10.1086/427456
Document language
English
Loading