Faster Hepatitis C Cure Confirmation: A Win for Underserved Communities

Millions globally live with Hepatitis C (HCV), a liver infection that can cause serious health problems. Fortunately, direct-acting antivirals (DAAs) have revolutionized treatment, offering a cure rate exceeding 95%. That said, the reality is a bit more complicated. the traditional 12-week waiting period after treatment to confirm the cure poses a significant barrier, especially for vulnerable populations.

A recent study from UC San Francisco, published in *Open Forum Infectious Diseases*, suggests that this waiting time could be significantly reduced. Researchers found that testing at the completion of treatment and four weeks post-treatment accurately predicted the 12-week outcome in a sample of people who inject drugs (PWID). This is crucial because PWID, along with those experiencing homelessness, financial insecurity, or facing stigma, often struggle with consistent access to healthcare. The traditional requirement of multiple clinic visits for testing can lead to undocumented cures and untreated infections.

The study, named "No One Waits" (NOW), focused on providing HCV treatment at the point of diagnosis in community settings. This approach addresses the logistical and social barriers that prevent many from completing the standard treatment protocol. The study involved 89 participants, primarily PWID experiencing homelessness, who were offered immediate treatment with a 12-week course of Sofosbuvir/Velpatasvir (SOF/VEL), a common DAA. Their blood serum was monitored for HCV RNA, the virus's genetic material, at the end of treatment, and at four and twelve weeks after.

The results were promising: undetectable HCV RNA at treatment completion predicted a cure at 12 weeks in 96.6% of cases, and undetectable HCV RNA at four weeks post-treatment predicted a cure in all cases. Critically, the study also effectively identified individuals who didn't clear the virus early, allowing for prompt re-engagement with care. In other words, this accelerated testing protocol didn't just speed up confirmation for successful treatments; it also ensured that those needing further intervention weren't lost to follow-up.

This research has important implications for the broader healthcare landscape. The ability to confirm a cure sooner, particularly in non-clinical settings, aligns with the growing trend of point-of-care diagnostics and decentralized healthcare. Imagine a future where mobile health clinics equipped with rapid HCV testing can immediately diagnose, treat, and confirm cures for vulnerable populations, all in a single visit or within a much shorter timeframe. This approach not only improves individual outcomes but also contributes to the broader goal of eliminating HCV as a public health threat.

Furthermore, the study's findings support the use of SVR4 (sustained virologic response at 4 weeks post-treatment) as an alternative endpoint for uncomplicated HCV cases. This shift could streamline clinical trials and accelerate the development of new and improved treatments. It also underscores the value of leveraging technology and innovative care models to reach underserved communities, bringing effective healthcare solutions to those who need them most.

Editor’s note: This article was independently written by the Scoopliner Editorial Team using publicly available information.