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Friday, 30th September 2005  
Saturday, October 1st is international hepatitis C awareness day. Identified in 1989, hepatitis C is a virus which can cause liver damage. In Ireland, it is most commonly acquired by illicit intravenous drug use with needle sharing. It may also be acquired by mother to baby transmission where the mother is hepatitis C positive and less commonly by unprotected sexual intercourse with an infected partner. One may also be infected by contaminated needles used for tattooing or body piercing. The risk of transmission by blood and blood products has been greatly decreased by enhanced surveillance and sensitivity of laboratory detection.

In the Dublin area there are an estimated 12,500 intravenous drug users, 50-80% of who are believed to have been infected with hepatitis C. Recent advances in treatment have resulted in viral clearance for many. This treatment is available through the hepatology and infectious disease services in the country. It has been recommended that drug users who are not actively abusing illicit drug or alcohol be referred for treatment and encouraged to adhere to treatment once offered. Many drug users are unaware that hepatitis C is a serious disease. Furthermore, many drug users fail to attend their outpatient appointments and do not stay on treatment once started. This is oftentimes a consequence of their chaotic lifestyles and poor social support. It may also be a consequence of relapse into active addiction or depression, common side effects of treatment.

To address the poor understanding of the disease in the drug using community, Dr. Shay Keating of The Drug Treatment Centre Board wrote an information booklet titled ‘Hepatitis C – a guide for drug users and their families’. This booklet has proven to be a popular education tool in the community. At The Drug Treatment Centre Board, a pilot study in which hepatitis C treatment was linked to methadone dispensing by directly observed therapy was performed. Direct links to the Infectious Disease service at St. James’s Hospital were established and psychiatric well being was closely monitored by the psychiatric staff of The Drug Treatment Centre Board. This study demonstrated that treatment adherence in this patient cohort could be facilitated by providing treatment in the centre. Following the success of the pilot study, this model of care has been offered to all suitable candidates at the centre.

29th September 2005

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