Are Direct-Acting Antivirals Effective in the Community Setting for Treating Hepatitis C in Persons with Intravenous Drug Use?

Although infection with hepatitis C virus (HCV) is curable, high-risk populations such as persons with intravenous drug use (PWID) can face significant barriers to treatment. Now, investigators report outcomes among a large cohort of PWID in Baltimore from 2006 to 2019, a period when direct-acting antivirals (DAAs) became available. In the cohort (82% Black, 34% HIV positive), 1323 participants had HCV RNA detected at ≥1 biannual visit. HCV treatment was not provided by the study but became more widely available through regular clinical care in 2015.

HCV RNA positivity rates fell from 100% at baseline (according to study entry criteria) to 48% by 2019. Also by 2019, 39% of participants self-reported receiving HCV treatment. Cirrhosis (define…