Mobile Telemedicine for Treating Chronic Hepatitis C Among Rural People Who Inject Drugs: A Randomized Clinical...

Area of Science:

• Public Health
• Infectious Diseases
• Telemedicine

Background:

• Rural populations who inject drugs face significant barriers to hepatitis C virus (HCV) testing and treatment.
• Direct-acting antiviral (DAA) therapies offer a cure for HCV, but access remains limited in many rural US communities.
• Effective interventions are crucial for achieving national HCV elimination goals.

Purpose of the Study:

• To evaluate a mobile telemedicine intervention for HCV treatment among rural persons who inject drugs.
• To determine if the intervention increases HCV treatment initiation and viral clearance.
• To assess the intervention's impact on reducing injection equipment sharing.

Main Methods:

• An open-label, randomized clinical trial compared mobile telemedicine care (MTC) with enhanced usual care (EUC).
• Both arms integrated van-based syringe services.
• Participants were adults with chronic HCV infection and a history of drug injection in rural New Hampshire and Vermont.

Main Results:

• Mobile telemedicine care (MTC) significantly increased HCV treatment initiation (57.3% vs 26.7%) and viral clearance (37.3% vs 18.7%) compared to EUC.
• No significant difference was observed in reducing injection equipment sharing between the groups.
• The study included 150 participants randomized to MTC or EUC.

Conclusions:

• Telemedicine integrated with mobile syringe services improves access to HCV treatment and cure for rural persons who inject drugs.
• This model demonstrates an effective strategy for reaching underserved populations with HCV care.
• Convenient, low-threshold telemedicine treatment is recommended for rural HCV elimination efforts.