Current Models to Address Obstacles to HCV Elimination

Abstract

To help inspire global action, the World Health Organization (WHO) has set an ambitious goal of eliminating viral hepatitis, including hepatitis C virus (HCV) infection, as a public health concern by 2030. Globally, an estimated 58 million people have chronic HCV infection, including over 4.5 million people who have recently injected drugs (PWID). Of the 1.5 million new infections occurring per year, over 43% are in this risk group. Systematic approaches are needed with this population to achieve the WHO elimination goals. A number of programs have been successful, most notably in Australia, Scotland, Iceland and North America. We still require additional programs that are easily accessible, multidisciplinary, durable and driven by patient-defined parameters of engagement. We have evaluated housing-based programs as community pop-up clinics to identify HCV-infected vulnerable inner-city residents and offer HCV treatment within such a context. This has been successful, with almost 300 individuals receiving treatment since January 2021, with an effective cure rate exceeding 98%, 99% retention in care, HCV reinfection rates below 1/100 person-years and reduced rates of opioid-related overdose deaths. The implementation of programs, such as ours, must be considered to achieve elimination of HCV infection among PWID on a worldwide basis.