BRINGING HEPATITIS C TREATMENT TO REGIONS OF ARMENIA: SUCCESSFUL COOPERATION WITH THE MINISTRY OF HEALTH ON DECENTRALIZATION OF TREATMENT AS PART OF THE CUTTS HEPC PROJECT

Author: Sargsyan K, Davtyan K, Ohanjanyan T, Nanushyan L, Hellard M, Stoove M, Schroeder S, Flynn M, Voloshin A, Scott N, Mikayelyan Z, Lamand P, Ferrand-Dehaes C, Wisse E, Madden A, Vickerman P, Mayilyan Z, Hovakimyan H, Grigoryan R, Davidyants A, Davidyants M, Mirzoyan M, Stepanyan N, Torosyan M, Tonoyan K, Evinyan N, Draper B, Pedrana A

Theme: Models of Care Year: 2025
Background:
Hepatitis C (HCV) remains a sighttps://airdrive.eventsair.com/eventsairaueprod/production-ashm-public/c844bd0f96834e80850ced6207a2b019nificant health burden among people who inject drugs (PWID), with limited access to diagnosis and treatment. Historically, the National HCV treatment program in Armenia has been centralized in Yerevan, limiting access in underserved regions. The Ministry of Health (MOH), together with Médecins du Monde (MDM) and partners, Burnet Institute, International Network of People who Use Drugs (INPUD), University of Bristol, launched the CUTTS Models of Care (MoC) study to pilot a simplified, decentralized HCV model of care (MoC) for PWID.

Model of care:
Initiated in October 2024, a non-randomised trial is evaluating two models: Arm 1 – simplified model of care and Arm 2 – “same day test and treat” model. The trial is being conducted in Yerevan and in three regions. Regional medical staff capacity is being enhanced through training, ongoing mentoring, and referral pathways for complex cases. The MoH provides Direct-Acting Antivirals (DAAs) for study participants.

Effectiveness:
As of February 28, 2025, 261 participants were enrolled: 60% (156/261) were HCV Ab positive and 54% (85/156) RNA positive, with higher RNA positivity in regionas 64% (54/84) compared to Yerevan 43% (31/72). In regional sites, among those with current HCV infection, seven had advanced fibrosis (including one of decompensated cirrhosis), compared with one case of cirrhosis in Yerevan.

Conclusion and next step:
Preliminary data shows high HCV exposure and infection rates, especially in regional sites, highlighting the need for decentralised, simplified care. The study has improved accessibility of treatment for PWID, particularly in regions. The study will explore the feasibility, scalability and cost-effectiveness of these models from a patient and health system perspective to understand how best to continue decentralisation of care.  

Disclosure of Interest Statement:
This study is supported by UNITAID, managed by MdM. DAAs donated by the MoH. No pharmaceutical grants were received. 
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