Hepatitis C cascade of care at an integrated community facility for people who inject drugs

Abstract

ObjectiveTo examine the hepatitis C virus (HCV) cascade of care at a community-based integrated harm reduction and treatment facility for people who inject drugs (PWID). MethodsQueensland Injectors' Health Network is a community-based agency providing integrated harm reduction and treatment services, including HCV treatment. Program data were analyzed from program commencement (early 2015) up to December 2017. ResultsBy December 2017, 476 participants with confirmed HCV infection had enrolled in treatment, of whom 72% had commenced treatment, 65% had completed treatment, and 44% had a confirmed sustained virologic response at 12-weeks post-treatment. Participants who commenced treatment tended to be older (ref 18–34 years; 35–49 years OR = 1.84, p = 0.037, 50+ years OR = 3.19, p = 0.002) and to feel safe and stable in their housing (OR = 2.36, p = 0.021). Participants who completed treatment were less likely to report legal issues (OR = 0.23, p = 0.009). ConclusionsIntegrated community-based services can successfully engage PWID throughout the HCV treatment journey. Additional social support, including linkage with housing and legal navigation services, may improve treatment uptake and completion. Point-of-care testing, including same-day scripting, could improve treatment uptake.