Harm reduction-based and peer-supported hepatitis C treatment for people who inject drugs in Georgia

Abstract Backgrounds Georgia faces high HCV rates (5.4% of chronic cases in general population) with an epidemic concentrated among people who inject drugs (PWID). A National HCV Elimination Program (NHCEP), was launched in April 2015, aiming to eliminate HCV by 2020. To succeed, this program must develop tailored interventions to enroll PWID in treatment. Intervention We implemented a pilot intervention to facilitate access to and retention of PWID in the NHCEP, and to prevent reinfection after treatment. Screening was offered at a harm reduction center. PWID with positive results were followed by peer-workers during medical assessment, which lasted 73 days in average, and throughout the treatment by Sofosbuvir and Ribavirin+/− PegInterferon for 12, 24 or 48 weeks delivered at a medical center. Additional prevention sessions and PCR checks were delivered to PWID 6 and 12 months after the confirmation of sustained virologic response. Results The pilot intervention screened 554 people in 5 months with 244 starting treatment. The majority of participants (98.0%, n = 239) completed the treatment. The intervention, initially implemented in the capital, was replicated in a rural area. Conclusion Peer-supported and strongly integrated, comprehensive HCV care will help PWID reach high uptake and adherence to care.