Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Julie Solberg


Hepatitis C; Direct acting antivirals; Drugs and alcohol; Public health


In the 1960’s, the hepatitis C virus (HCV) epidemic began mainly through the transmission of blood transfusions. By the time screening was implemented, millions had already become infected worldwide. After a decade of declining infection rates, a second wave started in the midst of the opioid epidemic in 2010. Prior to 2014 and the application of curative direct-acting antivirals, treatment was expensive, had low efficacy, many side effects, and long treatment durations. Advances in medicine have allowed for HCV elimination with shorter treatment durations, less side effects, and higher treatment rates. Unfortunately, treatment is not offered to all HCV patients due to current Medicaid restrictions and drug and alcohol abstinent requirements. This literature review aimed to investigate the effectiveness of treating HCV in active substance users. A comprehensive literature review was performed using electronic search databases PubMed, Embase, and CINHAL. Keywords used, along with MeSH words, included: hepatitis C, drugs, alcohol, economics, prevention and control, psychology, health care disparities, statistics and numerical data, health care quality, access and evaluation, and public health. The search results were limited to the last 10 years which yielded 30,397 articles. Exclusion criteria consisted of research on other variables with lacking data on substance use and HCV therapy completion. Studies with specific populations such as African Americans, pregnant patients and those with HCV/HIV co-infection were excluded. Research that was not completed in the United States (US) was also excluded. Current literature provides strong evidence in successful treatment regardless of substance use. Given the prevalence of those not receiving treatment and continual increase of HCV in the US, applying this research to clinical application could move us one step closer to HCV eradication.