Detection of liver disease in injection drug users

Detection of liver disease among injection drug users is an important challenge because liver disease is common, usually unrecognized, and treatable in early stages. Many forms of liver disease occur in injection drug users (IDUs). However, commensurate with its exceedingly high prevalence among IDUs, much of the published literature (and accordingly the focus of this review) regards liver disease caused by chronic hepatitis C. Existing guidelines for detection of liver disease are presented in the context of the current standard of care. Since recent research shows these guidelines rarely contribute to the medical management of IDUs, special emphasis is given to novel approaches that, when coupled with advances in treatment, the authors believe could substantially reduce the medical and psychological consequences of injection drug use.