Free hepatitis C treatment trial lowers community viral load in rural Kentucky

Key points:

• Kentucky viral hepatitis treatment program reduces proportion of hepatitis C viremic individuals in rural Appalachian county.
• Results were consistent after adjusting for age, sex, and drug user status.

BOSTON — A treatment trial that enrolled people with chronic hepatitis C virus infection and provided free medical care helped reduce the proportion of patients with viremia in a rural Appalachian county, data show.

Dr. Jennifer Havens, An infectious disease epidemiologist and professor at the University of Kentucky and colleagues sought to determine the effectiveness of Kentucky’s viral hepatitis treatment program by examining the proportion of viremic individuals screened and enrolled in the program from 2019 to 2023. Interventions include treatment with sobobuvir/velpatasvir, which is provided free of charge.

According to results presented at the Liver Meeting, the study included 748 individuals, of whom 76.9% were positive for HCV antibodies; of these, 64.9% had viremia. However, the researchers noted a significant decrease in the proportion of viremic individuals over time (ask < .001).

Multivariable models also showed that the odds of viremia were significantly lower during all follow-up periods compared with the first 6 months of recruitment (ie, before the COVID-19 pandemic). Furthermore, in the last 6 months of recruitment, from October 2022 to March 2023, the odds decreased by 69% compared with the first 6 months.

Additionally, women were 39% less likely to be viremic at screening compared with men, according to the results. However, the presence of chronic infection was not found to be associated with the age or condition of people who inject drugs.

The researchers noted that as the number of recoveries increased in the county, community hepatitis C viral loads also dropped significantly. They recommend that those at greatest risk of HCV transmission need continued treatment to eliminate HCV from this high-risk community.