Three-armed, cluster intervention study of hepatitis C viremia testing for people who inject drugs in Georgia

Author: Maia Japaridze Jessica Markby Ryan Ruiz Shaun Shadaker Maia Butsashvili Maia Tsereteli Maia Alkhazashvili Irma Khonelidze Sonjelle Shilton

Theme: Models of Care Year: 2021

Background: With a hepatitis C virus (HCV) prevalence of 7.7% in 2015, Georgia embarked on an elimination programme; however significant gaps remain in HCV care. Although screening programs have largely been decentralized for high risk groups, viremia testing remains a limiting factorfor persons who inject drugs (PWID). We describe two models of viremia testing that aim to address these challenges. Description of model of care/intervention: In a cluster, non-randomized intervention study, 8 harm reduction sites (HRS) were assigned to one of three arms. Arm1: GeneXpert on-site, Arm 2: blood draw on site for centralized HCV core antigen testing, Arm 3: standard of care with HCV antibody-positive patients referred to treatment centers for HCV RNA testing. The proportion of participants completed each step in the cascade were compared. Effectiveness: Between May 2018 and September 2019, 1671 HCV-seropositive participants were enrolled (Arm 1; n=620 Arm 2; n=486 Arm 3; n=565). Participants were predominantly male (95.4%), with a median age of 43 years (interquartile range: 37,50), and 77.2% were currently injecting drugs. Greater proportions of participants received viremia testing in both Arm 1 (100.0%) and Arm 2 (99.8%) compared to Arm 3 (91.3%) (1 versus 3 P

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