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%. However, the
traditional 12-week waiting period after treatment to confirm the cure poses a significant barrier, especially for
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
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.