Rapid hepatitis C test and treat with peer support at opioid treatment programs (RAPID HCV): a hybrid...

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• People who use drugs (PWUD) face significant barriers to hepatitis C virus (HCV) treatment, hindering global HCV elimination efforts.
• Integrating HCV testing and treatment services within opioid treatment programs (OTPs) presents a promising strategy to improve access and treatment uptake.

Purpose of the Study:

• To evaluate the effectiveness and implementation of an onsite HCV test and treat model within OTPs.
• To compare HCV treatment initiation rates between an onsite, integrated model and traditional offsite referral.

Main Methods:

• A multicenter, randomized controlled trial (RAPID HCV) involving PWUD with reactive antibody tests.
• Participants were randomized to either onsite OTP-delivered HCV test and treat with peer support or referral to offsite specialist care.
• The primary outcome was HCV treatment initiation within 12 weeks among treatment-eligible participants.

Main Results:

• Treatment initiation occurred in 89% of participants in the onsite group versus 21% in the referral group (p < 0.001).
• The study included 122 participants in the modified intention-to-treat population, with a median age of 49 years.
• No serious adverse events related to study procedures or HCV treatment were reported.

Conclusions:

• Onsite HCV test and treat integrated into OTPs significantly increases HCV treatment initiation compared to offsite referral.
• This integrated care model is an effective strategy for advancing HCV elimination among PWUD.