HCV infection is highly prevalent in Australian injecting drug users, with upward of 80% of infections related to substance injecting risk behaviours. HCV treatment has improved significantly over the last decade, with sustained viral responses seen at rates of 50% for genotype 1 and 80% for genotypes 2 and 3. However, only a small minority of chronically HCV infected people have received interferon/ribavirin treatment. Injecting drug users remain reluctant to receive hospital-based services for HCV treatment.

Approximately 38,000 opiate dependent users are maintained on methadone or buprenorphine maintenance in Australia, presenting an ideal population to receive treatment. The Enhancing Treatment For Hepatitis C In Opioid Substitution Settings (ETHOS) plans to recruit four to six opiate substitution clinics to deliver HCV treatment though community based drug services. Newcastle Pharmacotherapy services will be one of the services delivering HCV treatment. This paper will describe the model of care developed in the Newcastle clinic. This model includes liaison with the HCV nurse practitioner and liver clinic staff from the John Hunter Hospital, community based psychiatric support services and incorporates peer-based support for IDU receiving treatment.