Hepatitis C cascade of care at an integrated community facility for people who inject drugs

Objective: To examine the hepatitis C virus (HCV) cascade of care at a community-based integrated harm reduction and treatment facility for people who inject drugs (PWID). Methods: Queensland Injectors' Health Network is a community-based agency providing integrated harm reduction and treatment services, including HCV treatment. Program data were analyzed from program commencement (early 2015) up to December 2017. Results: By December 2017, 476 participants with confirmed HCV infection had enrolled in treatment, of whom 72% had commenced treatment, 65% had completed treatment, and 44% had a confirmed sustained virologic response at 12-weeks post-treatment. Participants who commenced treatment tended to be older (ref 18-34 years; 35-49 years OR = 1.84, p = 0.037, 50 + years OR = 3.19, p = 0.002) and to feel safe and stable in their housing (OR = 2.36, p = 0.021). Participants who completed treatment were less likely to report legal issues (OR = 0.23, p = 0.009). Conclusions: Integrated community-based services can successfully engage PWID throughout the HCV treatment journey. Additional social support, including linkage with housing and legal navigation services, may improve treatment uptake and completion. Point-of-care testing, including same-day scripting, could improve treatment uptake.