Theme: Clinical Research Year: 2019
Background: To achieve hepatitis C elimination, treatment programs need to be developed to engage,
treat, and cure people who are actively injecting drugs.
Methods: We present preliminary data from the first 65 participants in the Accessible Care intervention
for engaging people who inject illicit drugs (PWID) in hepatitis C (HCV) care. The randomized clinical trial
compares the effectiveness of Accessible Care (low-threshold care in a syringe service program located
in New York City) with Usual Care (referral to existing services) in facilitating linkage, engagement, and
retention in HCV care. Eligible participants were HCV RNA positive and had injected drugs in the past 90
days. We compared the percentage of participants in each arm linked to HCV care (defined as one visit
with HCV treatment provider), and initiated direct acting antiviral (DAA) treatment within 6 months of
enrollment.
Results: Among the 65 participants, mean age is 41.2 years; 28% are females; 73% homeless; 6% black,
51% Latina/o and 39% white. 82% of participants had injected drugs in the last 30 days, with an average
of 13.2 injections/month (median 10). Nearly all participants had health insurance, 88% public
insurance, 6% uninsured. 32 participants were randomized to the Accessible Care arm. Within 6 month
of enrollment 79% of the Accessible Care arm and 25% of the Usual Care arm had linked to HCV care,
and 69% and 13% had been started on DAA therapy, respectively. Of the 26 participants in the
Accessible Care arm started on DAA therapy, the median time from enrollment to treatment initiation
was 87.5 days [range 22-180].
Conclusion: Among HCV-infected PWID enrolled at a syringe service program, higher rates of linkage to
care and treatment initiation were seen in the Accessible Care arm where stigma- and shame-free
treatment was located within a community-based location.
Disclosure of Interest Statement: Drs. Eckhardt, Kapadia, and Marks have received research grants
from Gilead Sciences Inc. No pharmaceuticals grants were received in the development of this study.