Pioneering delivery of hepatitis C treatment for people who inject drugs

A pioneering study that employed innovative methods of delivering hepatitis C testing and treatment to people who inject drugs has published its findings.

The study, led by Glasgow Caledonian University (GCU) and the University of Bristol in collaboration with Public Health Scotland (PHS), NHS Tayside and Scottish Drugs Forum, provides recommendations on how best to get hepatitis C treatment to those who need it most, following a successful three-year trial in NHS Tayside.

Hepatitis C is a blood-borne virus that can seriously damage the liver and is spread mainly through blood-to-blood contact with someone who is infected. Despite effective opioid substitution therapy and needle syringe programmes, chronic hepatitis C prevalence remains at around 40% among people who inject drugs in the UK.

The current breakthrough in getting treatment to those who inject drugs will help guide efforts in Scotland to eliminate hepatitis C by 2024. It was studied as part of the National Institute for Health Research (NIHR) and funded EPIToPe (Evaluating the population impact of hepatitis C direct-acting antiviral treatment as prevention for people who inject drugs project) (external website).

Key recommendations include introducing a nurse-led community service for hepatitis C testing and treatment, recruiting peer workers who understand local drug cultures and creating close ties between existing community services for people who inject drugs.

The study’s findings state that the ideal model would be to house all these services in one building but where this is not possible the links between these services need to be strengthened including data sharing systems, role sharing and post-treatment care and support. A key part of that support is ongoing testing and treatment to prevent re-infection. It is hoped the guide will be rolled out across the UK and around the world.

Professor David Goldberg, Consultant at PHS and EPIToPe study Co-Investigator, said:

“The pioneering EPIToPe study has brought together a huge range of partner organisations over the past three years in an effort to determine how best to support people who inject drugs and who have hepatitis C with their treatment plans.

“By focussing on those who inject drugs and creating an innovative system that understands their needs, the study was able to make a huge difference to the lives of those who participated and the status of their infection. The results have been immensely promising, with NHS Tayside leading the way in efforts to eliminate the virus.

“It’s important that the learnings and roadmap of how to achieve such success is now shared widely throughout the rest of Scotland and other countries, so that progress can continue to be made within this population. This will be key to achieving the World Health Organisation global elimination targets”.

The World Health Organization has set an elimination target to reduce hepatitis C transmission by 80% and deaths by 65% by 2030, and researchers believe this new method of getting treatment to those who inject drugs in communities will have a major impact on cutting incidence and death rates. 

View the full recommendations in the study (external website)