Hepatitis C continuum of care and utilization of healthcare and harm reduction services among persons who inject drugs in Seattle

Background: To describe the "continuum of care" for hepatitis C virus (HCV) and related health service utilization among persons who inject drugs (PWID) in the Seattle metropolitan area. Methods: The study analyzed data from the 2015 National HIV Behavioral Surveillance system focused on PWID, which included local questions on HCV treatment and testing. We calculated respondent driven sampling (RDS)adjusted percentages of participants who had completed each step of the care continuum and compared healthcare harm reduction services among participants who were HCV + vs. HCV- using bivariate analyses. Results: 513 PWID were screened for HCV antibodies (Ab). Of those, 59.7% were HCV Ab +. Among those HCV Ab +, 86.4% had been tested for HCV at least once; 69.9% reported a previous diagnosis. Of those diagnosed, 55.9% had received a confirmatory test, 17.2% had ever received any medications for HCV, and 7.2% had completed treatment. The majority of HCV Ab + participants had seen a health care provider in the past 12 months (85.6%). Conclusions: There is a large gap between HCV screening and treatment among Seattle area PWID.