A Testing Campaign Intervention Consisting of Peer-Facilitated Engagement, Point-of-Care HCV RNA Testing, and Linkage to Nursing Support to Enhance Hepatitis C Treatment Uptake among People Who Inject Drugs: The ETHOS Engage Study

Viruses. 2022 Jul 16;14(7):1555. doi: 10.3390/v14071555.

Abstract

This study evaluated HCV treatment initiation among people who inject drugs (PWID) following an intervention of campaign days involving peer connection, point-of-care HCV RNA testing, and linkage to nursing support. ETHOS Engage is an observational cohort study of PWID attending 25 drug treatment clinics and needle and syringe programs in Australia (May 2018-September 2019). Point-of-care results were provided to the nurse, facilitating confirmatory testing and treatment. The study aimed to evaluate treatment uptake and factors associated with treatment at 24 months post-enrolment. There were 317 people with current HCV infection and eligible for treatment (median age 43, 65% male, 15% homeless, 69% receiving opioid agonist treatment, 70% injected in last month). Overall, 15% (47/317), 27% (85/317), 38% (120/317), and 49% (155/317) of people with current HCV infection had initiated treatment at 3-, 6-, 12-, and 24-months following testing, respectively. Homelessness (adjusted hazard ratio (aHR): 0.40; 95% confidence interval: 0.23, 0.71) and incarceration in the past 12 months (vs. never, aHR:0.46; 0.28, 0.76) were associated with decreased treatment initiation in the 24 months post-enrolment. This testing campaign intervention facilitated HCV treatment uptake among PWID. Further interventions are needed to achieve HCV elimination among people experiencing homelessness or incarceration.

Keywords: Hepatitis C virus elimination; Hepatitis C virus infection; Hepatitis C virus treatment; direct-acting antiviral era; people who inject drugs.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Drug Users*
  • Female
  • Hepacivirus / genetics
  • Hepatitis C* / diagnosis
  • Hepatitis C* / drug therapy
  • Hepatitis C* / epidemiology
  • Humans
  • Male
  • Point-of-Care Systems
  • RNA
  • Substance Abuse, Intravenous* / complications

Substances

  • Antiviral Agents
  • RNA

Grants and funding

The ETHOS Engage study is funded by a National Health and Medical Research Council (NHMRC) Partnership project grant (grant number 1103165), including funding from New South Wales Health and Cepheid. This study was also supported in part by a research grant from Investigator-Initiated Studies Program of Merck, Sharp and Dohme Corporation. The Kirby Institute is funded by the Australian Government Department of Health and Ageing. L.D. is supported by a US National Institute of Health (NIH), National Institute on Drug Abuse (NIDA) grant (R01DA1104470). G.J.D. is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (2008276). J.G. is supported by an NHMRC Investigator Grant (1176131). The contents of the published material are solely the responsibility of the individual authors and do not reflect the views of NHMRC.