Community-Led Hepatitis Care Model in India: Same-Day HCV Treatment Initiation at Drug Treatment Centers
Prevalence of hepatitis C virus (HCV) infection among people who inject drugs (PWID) in the state of Manipur, India, is 43%; however, access to care is poor. A community-led and comprehensive hepatitis care model, including same-day HCV treatment initiation at drug treatment centers, was piloted and presented at Harm Reduction Journal.
Screening was conducted through venipuncture samples collected by community peer PWID, using HCV antibody (HCV Ab) rapid screening and hepatitis B virus (HBV) surface antigen (HBsAg) rapid diagnostic tests. Reactive HCV Ab samples were tested for HCV RNA using near point-of-care Truenat® HCV on Truelab® Quattro. Eligible HCV RNA-positive participants were initiated treatment on the same day using direct-acting antivirals and followed for sustained virologic response. HBsAg-negative participants received rapid HBV vaccination regimen while those positive for HBsAg were tested for DNA and referred for treatment.
Community-led hepatitis care incorporating same day “test and treat” for HCV proved to be feasible and effective. HBV screening identified a large proportion of people who were unvaccinated. Extended peer support resulted in ensuring compliance to care and treatment cascade and completing all the three doses of HBV vaccination. As the screening, diagnostics infrastructure and vaccine are available in most countries with national viral hepatitis programs also in place, the model could be adapted or replicated to progress towards global elimination targets.