Hepatitis C (HCV) and HIV remain significant public health concerns in the U.S., particularly within the substance use disorder (SUD) community. These infections frequently co-occur, with rates substantially higher among individuals with SUD—especially those who inject drugs (PWID). The primary driver of this increased prevalence is needle-sharing, which serves as a direct risk factor for the transmission of both HCV and HIV.

Hepatitis C is a viral infection that primarily affects the liver, with an estimated 15% to 30% of individuals with SUD affected—particularly among those who inject drugs. According to the CDC, nearly 60% of PWID in the U.S. are infected with HCV. Similarly, HIV, which weakens the immune system, is disproportionately prevalent in this population, with an estimated 7% to 9% of PWID living with the virus. When these infections coexist, they can accelerate liver disease, increasing the risk of cirrhosis and hepatocellular carcinoma (HCC), the most common form of liver cancer.

The Critical Role of Screening

Many individuals with SUD are unaware they are living with HCV or HIV due to the asymptomatic nature of these infections in their early stages. Regular screening is essential for early detection and timely treatment, which can significantly improve health outcomes. For HCV, modern direct-acting antivirals (DAAs) offer a cure for most individuals. In the case of HIV, early intervention with antiretroviral therapy (ART) can effectively control the virus, preventing progression to AIDS and reducing transmission risk.

Without early screening and treatment, chronic HCV can lead to severe liver complications, including cirrhosis, liver failure, and HCC. Similarly, untreated HIV weakens the immune system, making individuals more susceptible to infections and worsening liver damage, especially in cases of co-infection with HCV. Both conditions can dramatically reduce life expectancy if left unaddressed, making proactive screening and treatment essential.

How PursueCare Is Making a Difference

At PursueCare, we believe in breaking down barriers to care by providing accessible, patient-centered addiction medicine. As a next-generation addiction medicine provider, we integrate comprehensive, multidisciplinary services to support long-term recovery and overall health.

We screen all new patients—and those returning to care after relapses—for HCV and HIV, ensuring early detection and timely intervention. Our providers treat most cases of HCV directly through our telehealth model and offer PrEP (pre-exposure prophylaxis) to prevent HIV infection. For complex cases, we collaborate with trusted community partners to ensure patients receive specialized care tailored to their needs.

Our mission goes beyond addiction treatment—we are committed to improving lives by addressing the full spectrum of health challenges faced by our patients. By integrating infectious disease screening and treatment into our addiction care model, we are reducing the burden of these conditions and empowering individuals to take control of their health.

If you or a loved one is struggling with substance use and at risk for HCV or HIV, PursueCare is here to help.

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Dr.Jason Kirby, DO, MBA, DFASAM is the Medical Director/Board Certified Addiction Medicine Specialist at PursueCare