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Hepatitis in alcohol and drug misusers: practical issues.

M E Cramp¹, R Williams¹

¹Institute of Liver Studies, King's College Hospital, Denmark HillInstitute of Hepatology, University College London Medical School, London, UK.

Addiction Biology

|January 7, 2016

Summary

Viral hepatitis (HBV and HCV) affects UK intravenous drug users and alcohol misusers. Screening and vaccination for HBV, alongside monitoring and specialist referral for HBV/HCV, are crucial for managing this public health issue.

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Area of Science:

Hepatology
Infectious Diseases
Public Health

Background:

Viral hepatitis, specifically Hepatitis B virus (HBV) and Hepatitis C virus (HCV), poses a significant health challenge within the UK's population of intravenous drug users (IVDUs) and individuals with alcohol misuse issues.
These infections can lead to severe liver damage and complications, necessitating targeted screening and management strategies.

Purpose of the Study:

To outline essential screening, vaccination, and referral protocols for viral hepatitis (HBV and HCV) in at-risk populations.
To discuss current and emerging treatment modalities for chronic viral hepatitis.

Main Methods:

The study emphasizes screening for HBV and HCV infection in patients attending drug rehabilitation clinics.
Recommendations include HBV vaccination for susceptible individuals (HBcAb negative) and liver function tests (LFTs) with specialist referral for those positive for HBsAg or HCV antibody.
Current management focuses on risk behavior modification and identifying suitable candidates for antiviral therapy.

Main Results:

Screening identifies individuals with HBV and HCV infections, allowing for timely intervention.
Vaccination against HBV is recommended for those without prior exposure.
Referral to specialist liver clinics ensures comprehensive evaluation and management for positive cases.

Conclusions:

Proactive screening, vaccination, and specialized care are vital for managing viral hepatitis in IVDUs and alcohol misusers.
While interferon therapy shows efficacy, its cost and monitoring requirements are considerable.
Advancements in antiviral agents and therapeutic vaccines are anticipated to significantly improve future treatment outcomes for chronic viral hepatitis.