Models of care for people who inject drugs and for opioid substitution treatment centres

About 80% of people infected with HCV in Australia have acquired the infection through sharing unsterile injecting equipment, and new infections almost exclusively occur in PWID. Although some practitioners previously excluded current PWID from treatment, there is clear evidence of equivalent treatment outcomes, albeit with a low risk of reinfection.15 Holistic care therefore includes harm reduction strategies such as opioid substitution therapy, together with access to needle and syringe programs. In addition, treating PWID may reduce HCV transmission (treatment as prevention), making this group a high priority for HCV treatment.16 Engagement with PWID and their injecting networks is recommended. The integration of HCV therapy with addiction therapy in opioid substitution treatment centres represents an opportunity to enhance HCV treatment uptake. Successful Australian models have been described, demonstrating feasibility and cost-effectiveness.17-19 Education and training of clinical staff at opioid substitution treatment centres to integrate HCV therapy with addiction therapy is therefore an important priority. Nurses can play a major and increasing role in this integration, through championing and facilitating HCV treatment in opioid substitution treatment centres and acting as an educational resource for medical practitioners prescribing HCV treatment in this setting.

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