New treatments for hepatitis C virus (HCV) infection have shorter, easier, oral regimens with fewer side effects and better outcomes. These represent a real opportunity to reduce the incidence of HCV-related cirrhosis and liver cancer among people already infected with HCV and to remove the virus from the ‘infection pool’, resulting in reduced transmission among people who inject drugs and the general population. Treating hepatitis C infection is an effective and cost-effective way to substantially reduce prevalence, especially in areas where it is high. Compliance with the new treatments is easier and can be further improved by well-planned support for patients.

Needle and syringe programmes (NSP) and opioid substitution treatment (OST) have been effective in capping English hepatitis C virus (HCV) rates at an average of around 50% among people who inject drugs.* There are wide geographical variations, with prevalence much higher in some cities and metropolitan areas. Sustained long-term increases in the coverage of NSP and OST could further reduce the virus’s prevalence.

The rate of treatment for hepatitis C in people who inject drugs is extremely low (just 3% of people estimated to be infected with chronic infections access treatment each year) but it can be improved by attention to assessment and engagement pathways, peer and other support, improved staff awareness and attitudes, and better access. Evidence also shows that addressing people’s healthcare needs, such as hepatitis, can help them progress in their drug recovery.

This briefing provides an overview of the key issues that local providers and commissioners of drug and hepatitis treatment should consider.