The article, “Training Providers of People Who Use Drugs to Offer Hepatitis C Treatment: A Washington State Initiative,” has been published in SAj in Volume 44 Issue 1-2.
In this commentary, the authors state that to address hepatitis C infection (HCV) treatment gaps among people who use drugs (PWUD), a statewide initiative trained buprenorphine waiver trainers to offer an optional HCV treatment module to waiver trainees. Five of twelve trained buprenorphine trainers went on to conduct HCV sessions at waiver trainings, reaching 57 trainees. Word-of-mouth led to multiple additional presentations by the project team, suggesting an unmet need for more education about treating HCV among PWUD. A post-session survey suggested that participant views on the importance of treating HCV among PWUD changed and that almost all felt confident to treat uncomplicated HCV.
In the AUTHORS’ OWN WORDS, they relate the importance of their work:
“Greater than 60% of new hepatitis C (HCV) infections in the United States now occur among people who inject drugs (PWID), with young people and those who use opioids most affected.1 Meanwhile, direct-acting antiviral (DAA) medications have dramatically improved the landscape of HCV treatment such that cure is expected with 8 to 12 weeks of well-tolerated oral medications.2 Targeting treatment to PWID is an important step to reduce forward transmission. Modeling studies of a “treatment as prevention” approach demonstrate that even modest increases in HCV treatment will reduce new infections and lower prevalence over time.3–5“
“A Washington State initiative to train buprenorphine waiver trainers to offer HCV treatment modules to waiver trainees trained 12 waiver trainers; 5 went on to conduct HCV trainings during the initial months of the program. Word-of-mouth invitations led to an additional 5 presentations by the project team. While a minority of those who attended these HCV trainings and presentations completed a post-session survey, most respondents reported their views were changed by the session, nearly all agreed that treating HCV among PWUD is important and nearly all reported confidence treating uncomplicated HCV.”
“We describe a statewide initiative to train and inspire buprenorphine waiver trainers to also conduct modules on treating HCV among PWUD. An unanticipated outcome was multiple invitations to disseminate the material more widely, suggesting an unmet need for education and support around HCV treatment among addiction-related audiences. Participants of HCV training sessions subsequently reported near universal belief in the importance of treating HCV and confidence in treating uncomplicated HCV. This work suggests that among providers who care for PWUD, limited HCV training may be adequate to change views about treating HCV among PWUD, although research specifically designed to evaluate efficacy would be helpful. Future studies could also evaluate models of care that would better support providers to treat PWUD for what is most often an easily curable disease.”