Hepatitis C infected drug users seem knowledgeable but not treated

Drug users intravenous HCV seem well informed about the health risks, but are scarcely treated for this infection, shows a study of associations and Asud SOS hepatitis, presented to the national meetings of the Risk Reduction organized Bobigny.

"Several studies have shown a very high prevalence of HCV, close to 75% among users or ex-users of intravenous drugs, leading to criticism of the effectiveness of the strategy to reduce risks," recalled President Asud Fabrice Olivet, told Reuters Health.

The association Autosupport drug users (Asud) and SOS hepatitis have circulated a questionnaire to eight pages (which lasts about 30 minutes) to users or former users of intravenous drugs on the perceptions of hepatitis C and that its treatment, their lifestyle with chronic hepatitis, clinical status, the level of support and information on viral hepatitis.

"Among the 450 users HCV who responded, the vast majority of them is part of a system of care and seems well informed about the disease and the risks associated with the virus," said Fabrice Olivet.

The results show that users have an image of hepatitis relatively consistent with reality. This view is similar to that of the general population.

In addition, 84% of patients saw a doctor about their HCV infection in the last twelve months, but less than half (46%) received treatment.

However, 36% of patients were offered treatment but declined mainly due to a fear of side effects of anti-HCV treatment (59%).

"We believe that the lack of information about the disease and its management is the key issue. The survey shows that users, but also the professional center management, meet a barrier to access care and screening, "said the president of SOS hepatitis, Michel Bonjour, in an analysis of this survey.

To remedy this, the association proposes to strengthen the multidisciplinary management of drug users (hepatologist, psychiatrist, general, CSST team, social workers outside the center ...) and to facilitate access to screening and care, in terms of time, for example, for patients who have lifestyles often disorganized.

She believes that the professionals who supervise addicts have problems related to the representation of hepatitis C and not always aware of the importance of treating this infection.

AWARENESS OF RISK

Regarding the perception of risk of transmission of hepatitis C, the respondents seem to have good information risk, since 90% of them believe that sharing needles is the vector of the greater risk.

"Our survey shows that users are well aware of the risk associated with HCV and the use of intravenous drugs and they were probably contaminated by other routes as syringes, such as cotton, spoons or water used in drug use, "said Fabrice Olivet.

Associations are concerned, however, the lack of awareness of the "young addicts" who have just entered the drug and does not seem to pay attention to instructions related to risk.

Indeed, the study showed a difference in perception and situation based on the age of the users or ex-users (roughly 40 years). It was revealed on the one hand, a sub-population of older patients now more established and more involved in the care and therefore both more aware of risk behaviors and transmission of hepatitis With a better understanding of hepatitis and its treatment, and the other, a younger population with the opposite characteristics.

These results confirm those of the seroprevalence survey Poppy published in the Weekly Epidemiological Bulletin (BEH) that show a very high prevalence among young users.