Theme: Clinical Research Year: 2025
Background:
Medically supervised injecting rooms (MSIRs) may be well-positioned to offer hepatitis C virus (HCV) testing and treatment as they serve people who inject drugs. This study aimed to determine the feasibility of treatment engagement amongst HCV-diagnosed clients of an MSIR in Melbourne, Australia, and examine factors associated with treatment initiation and return for post-treatment testing.
Methods:
From November 2020–December 2023, MSIR clients could participate in onsite pointof-care and/or venepuncture HCV RNA testing. Using sociodemographic, behavioural and clinical survey data collected at the first HCV test, we report the number and proportion tested, viremic, treatment-initiated, and underwent post-treatment testing following their first treatment episode. We defined post-treatment testing as completion of at least one HCV RNA test following treatment completion. Logistic regression assessed factors associated with treatment initiation and completion of post-treatment testing.
Results:
Of 1,157 participants tested, 291 had an active HCV infection. Most people (78%, 255/288) were male, 80% (215/269) were previously incarcerated and 21% (62/289) identified as Aboriginal and/or Torres Strait Islander. Ninety-three percent (270/291) of participants were prescribed treatment, 90% (242/270) initiated treatment and 60% (146/242) of those initiated returned for posttreatment testing. Overall, 50% (146/291) of HCV-diagnosed participants completed post-treatment testing. Participants who reported methamphetamine as the most commonly used drug in the past 6 months (n=34) were less likely to initiate treatment than those who used opioids (n=243) (aOR 0.28; CI: 0.10-0.74). High injection frequency of drugs at baseline (n=165) (≥15 days within the past month) was associated with completion of posttreatment testing (aOR 2.09; CI: 1.10-3.95).
Conclusion:
MSIRs are a feasible setting for the delivery of integrated HCV tests and treatment and attract high throughput. High injection frequency being associated with post- treatment testing supports MSIRs’ ability to engage those most at risk of HCV. Nonetheless, scale up is restricted by limited implementation of MSIRs nationally.
Disclosure of Interest Statement:
The Evaluation of Point-of-Care Hepatitis C testing and subsequent treatment uptake in persons who inject drugs visiting a Medically Supervised Injecting Room (EPOCH-SIR) study received funding or in-kind contributions from the Shepherd Foundation, Gilead Sciences, and the Victorian Department of Health & Human Services. No funding was received for this analysis.
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