28 October 2025
Tailored to individual locations, our HCV Intervention Symposia focus on the practical implementation of evidence-based HCV interventions such as point-of-care testing, dried blood spot testing, peer support, patient navigation and case finding. Here, Quinci Williams, from the Coalition for Global Hepatitis Elimination, shares the key takeaways from a recent symposium in Phoenix, Arizona, US.
Hepatitis C remains a major global health challenge, affecting an estimated 50 million people worldwide in 2022. Each year, nearly 1 million new infections occur, and approximately 240,000 people die from complications such as cirrhosis and liver cancer. Encouragingly, the number of new infections has declined compared to 2020, largely due to safer medical practices and expanded access to hepatitis C treatment. However, progress toward elimination remains uneven—by the end of 2022, only 36% of people living with hepatitis C had been diagnosed and just 20% had received treatment. These figures underscore the urgent need for continued collaboration, innovation, and investment to close the diagnosis and treatment gaps and accelerate progress toward global hepatitis C elimination.
On October 3, 2025, 42 participants from organizations such as VEN Centers, RIOT Phx, Cochise Harm Reduction, Arizona for NaphCare, and Arizona Department of Health Services met in Phoenix, Arizona, as part of the U.S. HCV Symposia tour, held in collaboration with the Coalition for Global Hepatitis Elimination (Task Force for Global Health) and NASTAD, and sponsored by AbbVie and Gilead. The event focused on practical, evidence-based hepatitis C interventions such as point-of-care and dried blood spot testing, peer support, patient navigation, and case finding. It highlighted effective models of care, key research, and shared lessons to help participants strengthen their own HCV programs.
Addressing the Burden in the United States
Since 2011, the United States has seen nearly a threefold increase in hepatitis C incidence. In 2023, 4,966 new cases were reported (1.5 per 100,000), though an estimated 69,000 new infections likely occurred, with injection drug use as the most commonly reported risk.
In Arizona, an estimated 61,500 people were living with hepatitis C between 2013 and 2016, corresponding to a prevalence of 1,210 cases per 100,000. The highest rates were observed in La Paz, Mohave, and Pima counties.
Social and structural factors, including drug overdose deaths, prescription opioid use, lack of health insurance, poverty, unemployment, and limited transportation, contribute to increased risk for acute HCV and HIV among PWID. Access to prevention remains limited: as of early 2017, only 270 syringe service programs (SSPs) were in operation nationwide, far short of the ~2,200 needed for adequate coverage. Additionally, only 30% of drug treatment facilities offer HCV testing, and just 14% of primary care patients with injection drug use–related conditions are screened, highlighting the urgent need to expand harm reduction and testing programs.
Enhancing the Care Cascade
Simplifying HCV testing and moving toward single-visit diagnosis and treatment is effective. The availability of highly effective HCV therapies has fueled optimism for global elimination. Advances in screening now support reduced-visit models for testing, diagnosis, and treatment, though ongoing adaptation of care models will be essential to sustain progress.
Barriers to HCV Testing/Screening/Diagnosis:
- Limited knowledge and confidence in HCV testing among healthcare providers, including general practitioners
- Low awareness of HCV and testing among patients
- Challenges with venous access in people who inject drugs
- Limited access to testing services, including labs and provider appointments
- Frequent changes in screening guidelines (risk-based → birth cohort → pseudo-universal)
- Barriers in remote or rural areas, such as sample transport and limited local expertise
- Stigma and discrimination related to HCV
- Mistrust of the healthcare system and gaps in insurance coverage
- Perceived high cost of testing and treatment
Solutions and Tools to Scale Up HCV Testing/Diagnosis and Care:
- Expand access to educational resources and peer-education programs
- Ensure testing and treatment are readily available and accessible (ex, point-of-care antibody testing, reflex RNA testing, dried blood spot)
- Strengthen privacy protections for individuals receiving a diagnosis and treatment plan
- Leverage telemedicine for those in remote areas or with difficulty accessing in-person care
- Improve data collection and surveillance systems
- Partner with local organizations to provide social support, including:
- Connecting individuals to treatment providers
- Supporting treatment initiation and completion
- Planning post-treatment strategies to prevent reinfection
- Maintaining engagement with preferred health services for ongoing testing and risk management
- Use incentives to encourage testing, treatment initiation, and adherence for both patients and providers
What’s Currently Available and Being Done:
- Rapid HCV and HIV testing is offered to houseless populations in Arizona alongside syringe exchange services. The program’s mobile, “on-the-go” approach—testing in markets, parks, and other community spaces—has successfully reached those most in need. By reducing stigma, communicating in an accessible language, and providing education on transmission, testing, and next steps after diagnosis, the program builds trust and promotes care engagement
- Outreach models for harm reduction and HCV care in rural Arizona use mobile services to reach people who inject drugs and houseless populations. Peer-led delivery has proven successful in maintaining confidentiality, providing essential supplies, and ensuring consistent care. However, to strengthen testing and linkage to care, additional funding, testing resources, and peer navigation programs are needed
- Partnerships and local advocacy strengthen testing and treatment efforts. Using GeneXpert technology allows for rapid, same-day testing and treatment initiation—leading to over a 70% higher chance of cure
