Chronic infection with the hepatitis C virus (HCV) is frequently
complicated by the presence of coexisting substance use
disorders (SUDs) and mental illnesses. Patients experience
multiple barriers to evaluation and treatment services, and
health care providers often experience uncertainty and
frustration in trying to provide those services. Chronic
hepatitis C is the leading cause of liver failure and subsequent
liver transplantation, a trend that will rapidly rise in the
next decade as the largest group of patients with chronic HCV
infection develops cirrhosis, hepatocellular carcinoma and liver
failure (Alter, 1997). Furthermore, antiviral treatment is now
achieving viral elimination in a substantial proportion of
patients, and efforts to improve treatment outcomes are
continuing (Saracco et al., 2003). Alcohol Consumption and HCV
Alcohol consumption is considered a cofactor in the natural
history of hepatitis C, although some consider that not enough
emphasis has been placed on its importance. Drinking ei