New Care Model Delivers Hepatitis C Treatment to Most Vulnerable
Victoria Colliver
University of California San Francisco
University of California San Francisco
October 23, 2023
By Victoria Colliver
First U.S. evaluation of a test-and-treat model in a neighborhood setting is a success.
Breakthrough treatments introduced over the last decade have transformed hepatitis C from a chronic and potentially deadly infectious disease into one that can be cured. But these medications have often been beyond the reach of those who are most vulnerable to the virus that causes it: people who inject drugs and lack stable housing.
To address this gap, researchers at UC San Francisco have developed a new model of care that brings medicine to people immediately after their diagnosis. The neighborhood-based, test-and-treat approach was as effective among injection drug users, many of whom were experiencing homelessness, as clinic-based hepatitis C treatment has been for the broader population.
Their study, published Oct. 20, 2023 in JAMA Network Open, is the first in the United States to evaluate such a program outside a health-care setting. It found that 92% of those who completed the treatment, along with a follow-up blood draw, had undetectable levels of the hepatitis C virus (HCV). Eighty-four percent had sustained virologic response, meaning they were cured three months after treatment.
“Offering hepatitis C treatment at the point-of-diagnosis streamlines care, saving both time and money,” said the study’s first author, Meghan D. Morris, PhD, MPH, an associate professor in the UCSF Department of Epidemiology & Biostatistics. “By delivering our ‘one-stop-shop’ model in a non-clinical setting it also tackles the major barrier preventing people who inject drugs and individuals from marginalized communities from accessing curative treatment: stigma.”
About 2.4 million Americans are living with hepatitis C, an insidious liver disease caused by a virus that is spread through the blood. The disease, which can cause severe liver damage, leads to about 15,000 deaths a year, according to federal statistics. Until the COVID-19 pandemic, HCV killed more Americans than all other reportable communicable diseases.
More than 80% of new hepatitis C infections are associated with sharing needles and syringes used for injecting drugs, and the increasing rate of new cases has corresponded to the growing use of opioids in recent years. The virus can also be transmitted through sex and via childbirth.
“Despite curative treatment, nearly half of people living with hepatitis C are unaware of it, and only a minority of those diagnosed are offered treatment.”
