Assessing feasibility of a modified same-day test-and-treat model for hepatitis C among rural people who inject drugs

Abstract

Background Despite advancements in hepatitis C virus (HCV) treatment, low uptake among hard-to-reach populations remains a global issue. The current study aimed to assess the feasibility of a modified same-day test-and-treat model in improving HCV care for people who inject drugs (PWID) living in resource-constrained rural areas. Methods A pilot study was conducted in four primary healthcare (PHC) centers in Malaysia. The model's key features included on-site HCV ribonucleic acid (RNA) testing using a shared GeneXpert® system; noninvasive biomarkers for cirrhosis diagnosis; and extended care to PWID referred from nearby PHC centers and outreach programs. The feasibility assessment focused on three aspects of the model: demand (i.e., uptake of HCV RNA testing and treatment), implementation (i.e., achievement of each step in the HCV care cascade), and practicality (i.e., ability to identify PWID with HCV and expedite treatment initiation despite resource constraints). Results A total of 199 anti-HCV-positive PWID were recruited. They demonstrated high demand for HCV care, with a 100% uptake of HCV RNA testing and 97.4% uptake of direct-acting antiviral treatment. The rates of HCV RNA positivity (78.4%) and sustained virologic response (92.2%) were comparable to standard practice, indicating the successful implementation of the model. The model was also practical, as it covered non-opioid-substitution-therapy-receiving individuals and enabled same-day treatment in 71.1% of the participants. Conclusions The modified same-day test-and-treat model is feasible in improving HCV care for rural PWID. The study finding suggests its potential for wider adoption in HCV care for hard-to-reach populations.

Decentralised same day test and treatment of hepatitis C levering existing peer support networks among men who inject drugs: feasibility and effectiveness

“…In this study, key portable laboratory instruments (GeneXpert®, FibroScan® and abdominal ultrasound) were transported to the community sites for screening [ 18 ]. Another study looking at same day test and treat among PWIDs in rural Malaysia used a GeneXpert® that shifted between clinics, in that study 71.1% (108/152) participants started treatment on the same day of the HCV RNA testing [ 19 ]. In our study, we demonstrated the feasibility of a simpler same day “test and treat” approach for HCV which does not require for the HCV RNA testing platform to be located on site by leveraging sample referral and coordinated peer navigation.…”

Correction: Assessing feasibility of a modified same-day test-and-treat model for hepatitis C among rural people who inject drugs

“…Following publication of the original article [ 1 ], in this article the affiliation details for Author A were incorrectly given as ‘Public Health Division, State Health Department, Alor Setar, Kedah, Malaysia’ but should have been ‘Public Health Division, State Health Department, Kuala Terengganu, Terengganu, Malaysia’.…”