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Hepatitis C Virus Infection among People Who Inject Drugs

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A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "Human Virology and Viral Diseases".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 10136

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Special Issue Editors

Prof. Dr. Jason Grebely

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Guest Editor

Kirby Institute, UNSW Australia, Kensington, NSW, Australia
Interests: hepatitis C and drug use

Dr. Alison D. Marshall

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Guest Editor

Kirby Institute, UNSW Australia, Kensington, NSW, Australia
Interests: hepatitis C and drug use; marginalised populations; hepatitis C treatment uptake; hepatitis C policy

Dr. Evan Cunningham

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Guest Editor

Kirby Institute, UNSW Australia, Kensington, NSW, Australia
Interests: hepatitis C; drug use; hepatitis C diagnosis; hepatitis C treatment; hepatitis C reinfection; interventions

Dr. Adelina Artenie

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Guest Editor

Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
Interests: hepatitis C prevalence; hepatitis C incidence; HIV-HCV co-infection; drug use; treatment uptake

Dr. Jack Stone

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Guest Editor

Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
Interests: hepatitis C surveillance; hepatitis C mathematical modeling; hepatitis C vaccine; people in prison

Special Issue Information

Dear Colleagues,

Hepatitis C (HCV) remains a global health challenge, with the World Health Organization (WHO) setting ambitious goals for its elimination. Achieving this goal requires substantial advancements in testing, treatment, and post-cure care. This Special Issue of Viruses aims to provide a comprehensive overview of the progress, challenges, and innovations in addressing HCV, with a particular focus on these critical aspects. The Special Issue will draw upon the expertise of contributors to highlight recent research and developments in combating this pressing health issue.

We invite submissions exploring the following key themes:

Advances in hepatitis C testing, including novel diagnostic technologies and strategies to enhance testing accessibility and uptake;
Strategies for improving linkage to hepatitis C care post-diagnosis, with a focus on re-engaging previously diagnosed individuals not connected to care;
Initiatives to enhance treatment initiation following diagnosis;
HCV reinfection following successful treatment for HCV;
The intersection of harm reduction, opioid agonist therapy, needle and syringe services, and access to hepatitis C care;
Integration of testing and treatment for hepatitis C and other infectious diseases (e.g., HIV, HBV, sexually transmissible infections);
Successful programs and case studies demonstrating hepatitis C control or elimination;
Interventions aimed at improving hepatitis C care for people who inject drugs.

We prioritise research that significantly contributes to our understanding of these areas, offering novel insights rather than reiterating previously published literature. Submissions evaluating interventions, elucidating care cascades, and providing evidence of infection control or elimination are particularly encouraged. We also seek papers with the potential to inform practice and policy in these domains. Furthermore, we actively encourage contributions from all geographic regions, including lower- and middle-income countries, and advocate for the inclusion of the perspectives and voices of people who use drugs in this collection.

Prof. Dr. Jason Grebely
Dr. Alison D. Marshall
Dr. Evan Cunningham
Dr. Adelina Artenie
Dr. Jack Stone
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

hepatitis C
HCV
testing
diagnostics
treatment
post-cure care
follow-up
reinfection
linkage to care
harm reduction
integrated care
elimination
people who use drugs
patient engagement
patient-centered care
healthcare intervention

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Published Papers (11 papers)

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11 pages, 2374 KiB

Open AccessArticle

Variability of Hepatitis C Treatment Cascade Outcomes among People Who Inject Drugs across Geographically Diverse Clinics in the US: The HERO Study

by Snehal S. Lopes, Moonseong Heo, Irene Pericot-Valverde, Brianna L. Norton, Lynn E. Taylor, Judith I. Tsui, Shruti H. Mehta, Judith Feinberg, Arthur Y. Kim, Paula J. Lum, Kimberly Page, Cristina Murray-Krezan, Jessica Anderson, Alain H. Litwin and the HERO Study Group

Viruses 2024, 16(10), 1551; https://doi.org/10.3390/v16101551 - 30 Sep 2024

Viewed by 665

Abstract

Heterogeneity of outcomes across different clinical trial study sites is often inevitable. Understanding how outcomes differ by site is important for planning future programs and studies. We examined the extent of heterogeneity of hepatitis C virus (HCV) treatment cascade outcomes among persons who inject drugs (PWIDs) across sixteen clinical sites utilized in the HERO Study—a pragmatic randomized trial of HCV treatment support. Treatment cascade outcomes included averages of overall treatment adherence and proportions of treatment initiation, treatment completion, sustained virologic response (SVR) test completion, and SVR achievement. The HERO study utilized 16 clinical sites across the United States (US): eight opioid treatment programs (OTPs) and eight community health centers (CHCs). Variability of the outcomes across the 16 clinical sites was assessed using ranges and intraclass correlation coefficients (ICC) estimated from mixed-effects linear or logistic regression models. Treatment initiation was analyzed in the intention-to-treat (ITT) sample (N = 755); treatment completion, adherence, and SVR test completion in the modified ITT (mITT) sample, which is the sample that initiated treatment (N = 623); and SVR achievement in the mITT and per-protocol (PP, N = 501) samples. Across the 16 clinical sites, the range observed in the averages of overall treatment adherence was from 68% to 81% [ICC = 0.026 (0.005, 0.054)], and the ranges of proportions observed were from 68% to 96% for treatment initiation [ICC (95% CI) = 0.086 (0.051, 0.155)], 60% to 100% for treatment completion [ICC = 0.049 (0.008, 0.215)], 54% to 95% for SVR test completion [ICC = 0.096 (0.006, 0.177)], 46% to 90% for SVR achievement in the mITT sample [ICC = 0.070 (0.014, 0.122)], and 76% to 100% for SVR achievement in the PP sample [ICC = 0.143 (0.021, 0.422)]. The variability of the outcomes across 16 US sites treating HCV among PWIDs appears to be substantial in view of the ranges and ICC values of the outcomes. It is imperative to develop tailored interventions to target the sources of variability and reduce barriers at the patient, provider, clinic, and state policy levels to facilitate more equitable access to HCV treatment and reduce heterogeneity in treatment outcomes. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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10 pages, 529 KiB

Open AccessArticle

Harm Reduction in Peer-Assisted Telemedicine for Hepatitis C: Secondary Outcomes of a Randomized Controlled Trial

by Hunter Spencer, Devin Gregoire, Gillian Leichtling, Megan Herink, Andrew Seaman, P. Todd Korthuis and Ryan Cook

Viruses 2024, 16(9), 1455; https://doi.org/10.3390/v16091455 - 13 Sep 2024

Viewed by 915

Abstract

Hepatitis C (HCV) treatment for people who use drugs (PWUD) decreases injection drug use and injection equipment sharing. We examined changes in injection drug use and injection equipment sharing following HCV treatment in a randomized trial comparing peer-assisted telemedicine for HCV treatment (TeleHCV) versus peer-assisted usual care in rural PWUD. We hypothesize that TeleHCV reduces risky behaviors and peers facilitate this change. We used mixed-effects logistic regression to describe participant-level (n = 203) associations between both injection drug use and injection equipment sharing and randomized groups, frequency of peer contact, HCV treatment initiation, HCV cure, and time. Risky behaviors were surveyed at baseline and 12 and 36 weeks after HCV treatment completion. Injection drug use declined more over time in TeleHCV participants vs. control at 12 weeks (adjusted odds ratio [aOR] = 0.42, 95% CI 0.20–0.87, p = 0.02) and 36 weeks (aOR = 0.48, 95% CI 0.21–1.08, p = 0.076). Injection drug use decreased more with a greater number of peer interactions, with reductions among participants in the 3rd quartile exceeding those in the 1st quartile of peer interactions at 12 weeks (aOR = 0.75, 95% CI 0.57–0.99, p = 0.04). Similarly, injection equipment sharing decreased over time, with reductions among participants in the 3rd quartile exceeding those in the 1st quartile of peer interactions at 36 weeks (aOR = 0.08, 95% CI 0.01–0.97, p = 0.047). Peer-assisted telemedicine for HCV treatment decreases injection drug use and injection equipment sharing; peers contribute to this effect. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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19 pages, 1907 KiB

Open AccessArticle

Syringe Access, Syringe Sharing, and Perceptions of HCV: A Qualitative Study Exploring the HCV Risk Environment in Rural Northern New England, United States

by Eric Romo, Elyse Bianchet, Patrick Dowd, Kathleen M. Mazor, Thomas J. Stopka and Peter D. Friedmann

Viruses 2024, 16(9), 1364; https://doi.org/10.3390/v16091364 - 27 Aug 2024

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Abstract

The ongoing hepatitis C virus (HCV) epidemic in the United States disproportionately affects rural people who inject drugs (PWID). This study explores the HCV risk environment in rural northern New England by examining PWID experiences and perceptions of HCV and injection equipment-sharing practices. We performed a thematic analysis on semi-structured interviews conducted with 21 adults with a history of injection drug use from rural New Hampshire, Vermont, and Massachusetts between April 2018 and August 2019. Salient themes included: (1) limited and varied access to sterile syringe sources; (2) syringe scarcity contributing to the use of informal syringe sources (e.g., secondary syringe exchange or syringe sellers who purchased syringes from out-of-state pharmacies); (3) syringe scarcity contributing to syringe sharing; (4) linkages among decisions about syringe sharing and perceptions of HCV risk, HCV status, and interpersonal trust; and (5) confusion and misconceptions about HCV, including difficulty learning one’s HCV status, inadequate HCV education, and misconceptions regarding HCV transmission and treatment. Efforts to prevent and eliminate HCV among rural PWID should expand syringe access, increase awareness of HCV as a serious but preventable risk, and acknowledge social connections as potential influences on syringe access and syringe-sharing decisions. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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12 pages, 436 KiB

Open AccessArticle

Distrust in the Health Care System and Adherence to Direct-Acting Antiviral Therapy among People with Hepatitis C Virus Who Inject Drugs

by Akhila Padi, Irene Pericot-Valverde, Moonseong Heo, James Edward Dotherow, Jiajing Niu, Madhuri Martin, Brianna L. Norton, Matthew J. Akiyama, Julia H. Arnsten and Alain H. Litwin

Viruses 2024, 16(8), 1304; https://doi.org/10.3390/v16081304 - 16 Aug 2024

Viewed by 750

Abstract

This study is a secondary analysis of a randomized clinical trial (October 2013–April 2017) involving 150 People Who Inject Drugs (PWIDs) with hepatitis C virus (HCV) seen in opioid agonist treatment programs in the Bronx, New York, and investigates the impact of distrust in the healthcare system on adherence to Direct-Acting Antivirals (DAAs) HCV treatment therapy among PWIDs. The distrust was scaled on a 9-item instrument and the adherence to DAA medications was measured using electronic blister packs. This study demonstrated a significant inverse relationship between levels of distrust and medication adherence: 71.8 ± 2.2% (se) vs. 77.9 ± 1.8%, p = 0.024 between participants with higher and lower distrust levels. Despite the absence of significant association of distrust with sociodemographic or substance use characteristics, these findings suggest that building trust within the healthcare system is paramount for improving adherence to DAAs among PWIDs. The results call for a healthcare approach that emphasizes trust-building through patient-centered care, sensitivity training, peer support, and health system reform to effectively address the treatment needs of this marginalized population. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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13 pages, 246 KiB

Open AccessArticle

Polysubstance Use and Related Risk Behaviors among People Who Inject Drugs in Kenya Preparing for Hepatitis C Virus Treatment

by Lindsey R. Riback, Mercy Nyakowa, John A. Lizcano, Chenshu Zhang, Peter Cherutich, Ann E. Kurth and Matthew J. Akiyama

Viruses 2024, 16(8), 1277; https://doi.org/10.3390/v16081277 - 10 Aug 2024

Viewed by 799

Abstract

Polysubstance use (PSU), injection drug use (IDU), and equipment sharing are associated with bloodborne infection (BBI) transmission risk, particularly Hepatitis C Virus (HCV), yet data on PSU in low- and middle-income countries (LMICs) is limited. We report on baseline PSU, medication-assisted treatment (MAT) engagement, and motivation to reduce IDU among 95 people who inject drugs (PWID) who accessed needle and syringe programs (NSP) in Nairobi and Coastal Kenya prior to HCV treatment. Bivariate and multivariate logistic regression were used to examine the associations between PSU and behaviors that confer HCV transmission and acquisition risks. Most participants (70.5%) reported PSU in the last 30 days, and one-third (35.8%) reported PSU exclusive to just heroin and cannabis use. Common combinations were heroin and cannabis (49.3%), and heroin, cannabis, and bugizi (flunitrazepam) (29.9%). Participants at baseline were receiving MAT (69.5%), already stopped or reduced IDU (30.5%), and were HIV-positive (40%). PSU was significantly associated with IDU (p = 0.008) and the number of times (p = 0.016) and days (p = 0.007) injected in the last 30 days. Participants reported high PSU and equipment sharing, despite high MAT engagement. While co-locating BBI treatment within existing harm reduction services is necessary to promote uptake and curb re-infection, tailored services may be needed to address PSU, particularly in LMICs. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

13 pages, 764 KiB

Open AccessArticle

Missed Opportunities: A Retrospective Study of Hepatitis C Testing in Hospital Inpatients

by Christine Roder, Carl Cosgrave, Kathryn Mackie, Bridgette McNamara, Joseph S. Doyle and Amanda J. Wade

Viruses 2024, 16(6), 979; https://doi.org/10.3390/v16060979 - 18 Jun 2024

Viewed by 1132

Abstract

Increasing testing is key to achieving hepatitis C elimination. This retrospective study aimed to assess the testing cascade of patients at a regional hospital in Victoria, Australia, who inject drugs or are living with hepatitis C, to identify missed opportunities for hepatitis C care. Adult hospital inpatients and emergency department (ED) attendees from 2018 to 2021 with indications for intravenous drug use (IDU) or hepatitis C on their discharge or ED summary were included. Data sources: hospital admissions, pathology, hospital pharmacy, and outpatients. We assessed progression through the testing cascade and performed logistic regression analysis for predictors of hepatitis C care, including testing and treatment. Of 79,923 adults admitted, 1345 (1.7%) had IDU-coded separations and 628 (0.8%) had hepatitis C-coded separations (N = 1892). Hepatitis C virus (HCV) status at the end of the study was unknown for 1569 (82.9%). ED admissions were associated with increased odds of not providing hepatitis C care (odds ratio 3.29, 95% confidence interval 2.42–4.48). More than 2% of inpatients at our hospital have an indication for testing, however, most are not being tested despite their hospital contact. As we work toward HCV elimination in our region, we need to incorporate testing and linkage strategies within hospital departments with a higher prevalence of people at risk of infection. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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14 pages, 400 KiB

Open AccessArticle

Hepatitis C (HCV) Reinfection and Risk Factors among Clients of a Low-Threshold Primary Healthcare Service for People Who Inject Drugs in Sydney, Australia

by Phillip Read, Bruce Zi Huan Tang, Edmund Silins, Anna Doab, Vincent J. Cornelisse and Rosie Gilliver

Viruses 2024, 16(6), 957; https://doi.org/10.3390/v16060957 - 13 Jun 2024

Cited by 1 | Viewed by 874

Abstract

Hepatitis C (HCV) reinfection studies have not focused on primary healthcare services in Australia, where priority populations including people who inject drugs (PWID) typically engage in healthcare. We aimed to describe the incidence of HCV reinfection and associated risk factors in a cohort of people most at risk of reinfection in a real-world community setting. We conducted a secondary analysis of routinely collected HCV testing and treatment data from treatment episodes initiated with direct-acting antiviral (DAA) therapy between October 2015 and June 2021. The overall proportion of clients (N = 413) reinfected was 9% (N = 37), and the overall incidence rate of HCV reinfection was 9.5/100PY (95% CI: 6.3–14.3). Reinfection incidence rates varied by sub-group and were highest for Aboriginal and/or Torres Strait Islander people (20.4/100PY; 95% CI: 12.1–34.4). Among PWID (N= 321), only Aboriginality was significantly associated with reinfection (AOR: 2.73, 95% CI: 1.33–5.60, p = 0.006). High rates of HCV reinfection in populations with multiple vulnerabilities and continued drug use, especially among Aboriginal and Torres Strait Islander people, highlight the need for ongoing regular HCV testing and retreatment in order to achieve HCV elimination. A priority is resourcing testing and treatment for Aboriginal and/or Torres Strait Islander people. Our findings support the need for novel and holistic healthcare strategies for PWID and the upscaling of Indigenous cultural approaches and interventions. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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14 pages, 916 KiB

Open AccessArticle

Virologic Response and Reinfection Following HCV Treatment among Hospitalized People Who Inject Drugs: Follow-Up Data from the OPPORTUNI-C Trial

by Kristian Braathen Malme, Kathrine Stene-Johansen, Ingvild Klundby, Øystein Backe, Tarjei Foshaug, Maria Helseth Greve, Charlotte Meinich Pihl, Ane-Kristine Finbråten, Olav Dalgard and Håvard Midgard

Viruses 2024, 16(6), 858; https://doi.org/10.3390/v16060858 - 27 May 2024

Cited by 1 | Viewed by 842

Abstract

Treatment of hepatitis C among people who inject drugs (PWID) may be complicated by loss to follow-up and reinfection. We aimed to evaluate sustained virologic response (SVR) and reinfection, and to validate complete pharmacy dispensation as a proxy for cure among PWID enrolled in a trial of opportunistic HCV treatment. Data were obtained by reviewing the electronic patient files and supplemented by outreach HCV RNA testing. Reinfection was defined based on clinical, behavioral, and virological data. Intention to treat SVR ≥ 4 within 2 years after enrolment was accomplished by 59 of 98 (60% [95% CI 50–70]) during intervention conditions (opportunistic treatment) and by 57 of 102 (56% [95% CI 46–66]) during control conditions (outpatient treatment). The time to end of treatment response (ETR) or SVR ≥ 4 was shorter among intervention participants (HR 1.55 [1.08–2.22]; p = 0.016). Of participants with complete dispensation, 132 of 145 (91%) achieved ETR or SVR > 4 (OR 12.7 [95% CI 4.3–37.8]; p < 0.001). Four cases of reinfection were identified (incidence 3.8/100 PY [95% CI 1.0–9.7]). Although SVR was similar, the time to virologic cure was shorter among intervention participants. Complete dispensation is a valid correlate for cure among individuals at risk of loss to follow-up. Reinfection following successful treatment remains a concern. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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12 pages, 909 KiB

Open AccessArticle

Evaluation of a Project Integrating Financial Incentives into a Hepatitis C Testing and Treatment Model of Care at a Sexual Health Service in Cairns, Australia, 2020–2021

by Joshua Dawe, Carla Gorton, Rhondda Lewis, Jacqueline A. Richmond, Anna L. Wilkinson, Alisa Pedrana, Mark Stoové, Joseph S. Doyle and Darren Russell

Viruses 2024, 16(5), 800; https://doi.org/10.3390/v16050800 - 17 May 2024

Viewed by 1065

Abstract

Background: Understanding the effectiveness of novel models of care in community-based settings is critical to achieving hepatitis C elimination. We conducted an evaluation of a hepatitis C model of care with financial incentives that aimed to improve engagement across the hepatitis C cascade of care at a sexual health service in Cairns, Australia. Methods: Between March 2020 and May 2021, financial incentives were embedded into an established person-centred hepatitis C model of care at Cairns Sexual Health Service. Clients of the Service who self-reported experiences of injecting drugs were offered an AUD 20 cash incentive for hepatitis C testing, treatment initiation, treatment completion, and test for cure. Descriptive statistics were used to describe retention in hepatitis C care in the incentivised model. They were compared to the standard of care offered in the 11 months prior to intervention. Results: A total of 121 clients received financial incentives for hepatitis C testing (antibody or RNA). Twenty-eight clients were hepatitis C RNA positive, of whom 92% (24/28) commenced treatment, 75% (21/28) completed treatment, and 68% (19/28) achieved a sustained virological response (SVR). There were improvements in the proportion of clients diagnosed with hepatitis C who commenced treatment (86% vs. 75%), completed treatment (75% vs. 40%), and achieved SVR (68% vs. 17%) compared to the pre-intervention comparison period. Conclusions: In this study, financial incentives improved engagement and retention in hepatitis C care for people who inject drugs in a model of care that incorporated a person-centred and flexible approach. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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7 pages, 201 KiB

Open AccessBrief Report

A Pilot Randomised Controlled Trial Involving Financial Incentives to Facilitate Hepatitis C Treatment Uptake Among People Who Inject Drugs: ETHOS Engage Study

by Alison D. Marshall, Anna Conway, Evan B. Cunningham, Heather Valerio, David Silk, Maryam Alavi, Shane Tillakeratne, Alexandra Wade, Thao Lam, Krista Zohrab, Adrian Dunlop, Craig Connelly, Victoria Cock, Carina Burns, Charles Henderson, Michael Christmass, Gregory J. Dore and Jason Grebely

Viruses 2024, 16(11), 1763; https://doi.org/10.3390/v16111763 - 12 Nov 2024

Viewed by 404

Abstract

The primary aim of this study was to establish the feasibility of implementing a larger RCT designed to evaluate the effect of financial incentives on HCV treatment initiation among persons receiving opioid agonist therapy and/or who have injected drugs in the prior six months. ETHOS Engage is an observational cohort of participants recruited from drug treatment and needle and syringe programs in Australia. Among 11 drug and alcohol clinics, participants who were HCV RNA-positive were randomized (1:1) to receive standard of care or a AUD $60 gift card at treatment initiation. Regarding feasibility, 100% (57/57) of eligible participants enrolled to take part. Twenty-eight participants were randomised to the financial incentive arm (AUD $60 gift card) plus standard of care and 29 participants to the standard of care arm. In this pilot RCT (n = 57), median age was 42 years (IQR 37–49), 63% were male (n = 36), 35% Indigenous (n = 20) and 36% (n = 21) reported injecting drugs daily in the past month. Twelve weeks post-study enrolment, 11 (39%) participants in the financial incentive arm and 17 (59%) participants in the standard of care arm initiated HCV treatment. Findings indicate high feasibility among people who inject drugs to be randomised to receive financial incentives to initiate HCV treatment. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

7 pages, 189 KiB

Open AccessCommentary

More than Just Buying a Van: Lessons Learned from a Mobile Telehealth HCV Testing and Treatment Study

by Elyse Bianchet, David de Gijsel, Lizbeth M. Del Toro-Mejias, Thomas J. Stopka, Randall A. Hoskinson, Jr., Patrick Dowd and Peter D. Friedmann

Viruses 2024, 16(9), 1388; https://doi.org/10.3390/v16091388 - 30 Aug 2024

Viewed by 761

Abstract

Hepatitis C virus (HCV) disproportionately affects people who inject drugs (PWID). Although HCV has become universally curable since the arrival of direct-acting antivirals, barriers exist to facilitating care and cure in this historically hard-to-reach population, including limited testing and healthcare services and healthcare stigma, issues that are compounded in rural areas. Telehealth is effective in increasing access to HCV care and cure, but innovative approaches of testing and care are required to fully address the need among rural PWID, which led to our study examining a mobile telehealth model for treating HCV. In this commentary, we discuss lessons learned delivering telehealth on a mobile unit, important factors for consideration when designing a mobile intervention, and we suggest an ideal model to increase access to HCV testing and treatment and other services for rural PWID. Full article

(This article belongs to the Special Issue Hepatitis C Virus Infection among People Who Inject Drugs)

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