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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
PubMed

Insights

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.

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.

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