Cohort study demonstrates high cure rates in people who inject drugs receiving community hepatitis C treatment, suggesting integrated models improve rural healthcare engagement.
Many people who inject drugs (PWID) who are infected with chronic hepatitis C virus (HCV) cannot engage with secondary care services due to social and geographical difficulties. The Cornish HCV management model integrates hospital-based hepatology and community drug and alcohol services, such as Addaction. Community blood-borne virus (BBV) screening is performed by Addaction staff. BBV nurses discuss results with patients. Results are reviewed at multidisciplinary meetings with the hepatology secondary care team with regard to a management plan. Patients were then treated either in the community by a BBV nurse or in secondary care. The community-based treatment of 43 HCV-positive PWID (2008–2012) resulted in a sustained virological response rate of 72% across genotypes 1–3 with only a 5% failure to complete therapy. This integrated model can help to increase HCV treatment rates in Cornwall and provide a national model for HCV treatment, particularly in non-urban areas.
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Hampton et al. (2015) studied this question.
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