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Getting to the Point: A Community-Designed, Low-Barrier Hepatitis C Testing and Treatment Program for People Who

Amanda N Perry1, Elizabeth Eccles2, Shoshana H Bardach1

  • 1The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA.

Viruses
|December 31, 2025
PubMed
Summary

A community-based hepatitis C virus (HCV) testing program successfully engaged people who inject drugs (PWID). However, significant patient drop-off occurred during treatment and follow-up, highlighting the need for improved retention strategies in HCV care.

Keywords:
HCVHCV treatmentPWIDhepatitis Clinkage to carepeople who inject drugspoint-of-care testingsyringe service program

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Addiction Medicine

Background:

  • People who inject drugs (PWID) face elevated risks for hepatitis C virus (HCV) infection.
  • Traditional healthcare systems often fail to adequately serve PWID.
  • Effective HCV elimination strategies necessitate the treatment of PWID.

Purpose of the Study:

  • To design and implement a novel, community-based care model for HCV testing and treatment tailored to PWID.
  • To assess the feasibility and engagement of a point-of-care (POC) testing program integrated with syringe services.
  • To evaluate the HCV care cascade within this high-risk population.

Main Methods:

  • A syringe service program delivered POC HCV and HIV antibody testing.
  • Facilitated access to healthcare providers, care navigation, and financial incentives were provided.
  • Participant data on demographics, drug use, testing, treatment history, and communication preferences were collected.
  • Descriptive analyses tracked testing, seropositivity, pre-treatment completion, treatment initiation and completion, and sustained virologic response at 12 weeks (SVR12).

Main Results:

  • The program engaged 464 individuals, with a 24.9% HCV seropositivity rate among 389 tested.
  • Of 164 individuals with positive tests or known diagnoses, 52 were viremic, and 35 initiated and completed treatment.
  • Only 9 out of 35 (25.7%) achieved SVR12, with 65.7% pending SVR12 determination.

Conclusions:

  • An incentivized, community-based POC testing program effectively engaged high-risk PWID for HCV and HIV services.
  • Significant attrition was observed across the HCV care cascade, especially in SVR12 determination.
  • Enhanced strategies are crucial to improve retention and optimize outcomes throughout the entire HCV care continuum.