Outcome of Hepatitis C Screen-and-Treat Program at a Drug Rehabilitation Centre in Perlis State

Hepatitis C virus (HCV) infection is prevalent among people who inject drugs globally and in Malaysia. Drug rehabilitation centres (PUSPEN) offer opportunities for intervention, but the feasibility of HCV care cascades in these settings requires evaluation. This study aims to evaluate the outcome of an integrated HCV screen-and-treat program implemented at PUSPEN Perlis, Malaysia.

This retrospective cohort study analysed data from an HCV screen-and-treat program conducted between October 2022 and December 2023 at PUSPEN Perlis. The program involved initial screening with rapid antibody testing, confirmatory HCV RNA testing, APRIbased fibrosis assessment, and Direct-Acting Antiviral (DAA) treatment, with Sustained Virologic Response at 12 weeks post-treatment (SVR12) as the primary outcome.

Screening of 461 participants during study period identified 62 (13.4%) as HCV antibody positive. Significant attrition occurred before confirmatory testing, with 34 (54.8%) undergoing HCV RNA tests, of whom 33 (97.0%) were positive. Treatment initiation was also limited, with 17 (51.5%) starting DAA therapy, primarily due to anticipated short rehabilitation stays. One participant transferred during therapy; the remaining 16 completed the 12-week regimen, all achieving SVR12 (100%) without reported adverse effects.

HCV screen-and-treat programs are feasible in Malaysian drug rehabilitation centres but face challenges in linkage to confirmatory testing and treatment initiation, largely due to limitations imposed by the duration of stay. While DAA therapy is highly effective when completed, strategies addressing diagnostic streamlining, potentially shorter regimens, and continuity of care post-release are crucial to optimise HCV elimination efforts in this vulnerable population.