14 November 2024
Last month at INHSU 2024 in Athens, Greece, we heard from global experts on innovative strategies to eliminate hepatitis C, including groundbreaking approaches to testing, treatment, and data collection. Here, we share key findings from some of the most impactful sessions. Recordings will be available in the coming months.
Global, Regional, and Country-Level Estimates of New HCV Infections Attributed to Injection Drug Use
Dr. Adelina Artenie from the University of Bristol presented on “Global, Regional, and Country-Level Estimates of New HCV Infections Attributed to Injection Drug Use.” Key findings and takeaways included:
- Very few countries have empirically measured baseline HCV incidence data for people who inject drugs to guide their strategies towards HCV elimination.
- Using a combination of methods and HCV antibody prevalence data, Adelina and colleagues expanded the number of countries with incidence data in people who inject drugs:
- For the <2015 period, HCV incidence was estimated at 14.6/100py (12.8 – 16.5; n=81 countries). Conversely, for the ³2015 period, HCV incidence was 10.3/100py (8.1 – 12.9; n=97 countries).
- Based on 73 countries with data for both time periods, the incidence rate ratio for ³2015 vs <2015 was 0.77 (95%UI: 0.63-0.96), suggesting a decline over time.
- Based on ³2015 HCV incidence, the global number of new annual HCV infections attributed to injecting drug use is 1,015,030 (95%UI: 567,930–1,796,490), with approx. 2/3 of new infections occurring in the US, India, China, and Russia.
“These data are very important in providing some insight into global HCV incidence among people who inject drugs and trends over time. However, these also highlight a very important need to do better in terms of measuring HCV incidence data among people who inject drugs, particularly in some regions of the world like the African region, and to strengthen HCV prevention and treatment in this population if we want to achieve HCV elimination,” Dr Artenie said.
Rapid Hepatitis C Treatment Access with Peer Support at Opioid Treatment Programs in North America
Associate Professor Oluwaseun Falade-Nwulia from Johns Hopkins University presented findings from the RAPID Hepatitis C Treatment study. The study, a multicenter randomized controlled trial conducted across five opioid treatment programs (OTPs) in the U.S. and Canada, explored the effectiveness of integrating HCV treatment into OTPs with peer support. The trial compared two groups:
- Onsite treatment with peer support:
- Immediate linkage to a trained peer (OTP client with lived experience of HCV) for HCV treatment initiation and adherence support.
- Onsite HCV treatment at OTP provided by a designated OTP staff member.
- Access to study drug (glecaprevir/pibrentasvir).
- Offsite specialist referral:
- Standard of care linkage to a local specialist center for HCV treatment.
- Access to study drug (glecaprevir/pibrentasvir).
The results demonstrated significantly higher treatment initiation rates in the peer-supported group, plus a far shorter treatment initiation timeline—just 19 days versus 50 days in the standard care group.
Participants and staff found the test-and-treat model with peer support highly acceptable, proving more efficient in overcoming barriers to care. However, the study also highlighted the need for additional resources, including funding and administrative support, to implement this model effectively at scale.
A National Program to Scale-Up Point-of-Care Testing and Treatment for Hepatitis C in Australia (2022-2024)
Prof. Jason Grebely from the Kirby Institute, UNSW, presented updated and impressive results from the Australian Hepatitis C Point-of-Care Testing Program at INHSU 2024. Since 2022, the program has trained 355 operators and performed 31,818 HCV tests across various settings, including drug treatment clinics, NSPs, prisons, mental health services, and mobile outreach.
Fingerstick point-of-care HCV RNA testing enables both diagnosis and treatment in a single visit, increasing testing acceptability and reducing loss to follow-up. The program achieved a remarkable 77% overall treatment uptake, with an even higher rate of 91% in prisons, where high-risk individuals are often harder to reach.
Prof. Grebely emphasized the significant reduction in barriers to care through point-of-care testing, particularly in prison settings. A short film was also shown, highlighting the program’s impact in prisons.
How Drones Are Helping Test and Treat Hepatitis C in Indian Prisons
We caught up with Ajeet Singh Bhadoria from AIIMS Rishikesh to hear about their amazing work using drones, self-testing kits, telehealth, and more to help test and treat hepatitis C in Indian prisons. Watch the video on our Instagram.
Beyond Hep C: Reducing Deaths From Chronic Liver Disease in People Who Inject Drugs Through Holistic Models of Care
People who inject drugs are well known to be at increased risk of hepatitis C infection and related liver disease. However, people who inject drugs are also at risk of other chronic liver diseases, which significantly impact quality of life and survival. Jessica Howell, Associate Professor Jessica Howell, Burnet Institute, Melbourne, Australia, chaired a session exploring ways to improve liver health for people who inject drugs through holistic models of care, looking beyond siloed hepatitis C testing and treat approaches. Findings included:
- Alcohol and malnutrition have a major impact on liver cirrhosis, liver cancer and overall survival for people who inject drugs
- Alcohol misuse impacts engagement and retention in care
- Holistic models of care that encompass all facets of liver health and retain people in care are essential to reduce deaths among people who inject drugs
Panellists include Dr Kate Dunn from York University, Mr Troy Combo from Burnet Institute, Dr Brian Conway from Vancouver Infectious Diseases Centre, Ms Anne Craigie from St Vincent’s Hospital Melbourne, and Dr Bec Winter from Burnet Institute.
The Importance of Data in Eliminating Hepatitis C
We caught up with Robert Fair from Hep CU Later in the UK to discuss his poster on the importance of data in finding, testing, and treating hepatitis C. Watch the video on our Instagram.
