Co-localized Substance Use and Hepatitis C Treatment

In the US, there has been a dramatic rise in hepatitis C infection and a shifting demographic with the highest rates in persons aged 20-39 years. Injection drug use is the most common mode of transmission. While many novel strategies to expanding hepatitis C treatment have been proposed, there has been little reported progress toward establishing a standardized, wide scale approach. In response, we developed a pilot quality improvement program combining screening and initiation of hepatitis C treatment utilizing a simplified algorithm adapted for the office based opioid treatment (OBOT) to provide co-localization of substance use and hepatitis C treatment.

Initial results revealed a high rate of seroprevalence among screened OBOT patients highlighting several challenges faced by this population including lack of awareness of infection and barriers to accessing care. Within this same group, 48.2% had either initiated or completed their course of DAA treatment within the first 6 months of the intervention phase of the program. Targeting patients in outpatient substance use treatment could identify a subset of at risk individuals with a high propensity for engaging and facilitate following through with hepatitis C treatment. On site treatment is an efficient alternative for treatment.