The epidemiological data suggests that people who use drugs (PWUDs) are the most important “reservoir” for the spread of HCV infection. For this reason PWUDs should be included in all HCV elimination plan as priority target for treatment.
We performed an observational study in 5 Italian Drug Abuse Services (SerDs) with the main aims to determine: 1) the prevalence of HCV infection in PWUDs; 2) the most important barriers to HCV treatment.
Of the about 4,000 drug users included in the study only about the 36% was tested and of them the 20% were anti HCV positive; only about the 60% of the HCV RNA positive patients were treated.
The study showed several important barriers to the screening, especially when cannot used rapid tests and/or if test is not proposed periodically, and to the linkage to care, in particular when the HCV treatment cannot be given inside the SerDs.
The study has also revealed as the harm reduction measures as suggested by WHO are not offered to all PWUDs.
In conclusion the study suggests how inside the SerDs the barriers for HCV treatment that can be overcome with a simpler model of treatment as represented by the point of care.