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Comparing Outcomes of the Hepatitis C Virus Cascade of Care Between a Peer-Led Program and Drug Treatment Services in England, 2019-2023
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DOI：10.1177/00333549261451180.png)
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Abstract
En 中文
<jats:sec>
<jats:title>Objectives:</jats:title>
<jats:p>The United Kingdom has committed to World Health Organization goals to eliminate hepatitis C virus (HCV) by 2030. Peer-led services (PLS) may enhance health care engagement and treatment outcomes. We compared progression through the HCV care cascade between those tested in a community using PLS (PLS group) with a population tested in drug services (non–PLS group) in England.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods:</jats:title>
<jats:p>
We extracted data on individuals with HCV-RNA test results from a laboratory surveillance system (2019-2023) and linked them to a national HCV treatment database. We identified individuals tested by the Hepatitis C Trust as having received PLS. We compared differences along the care cascade using the Pearson χ
<jats:sup>2</jats:sup>
test.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results:</jats:title>
<jats:p>
A total of 14 094 individuals in the PLS group (72.9% male; median age, 43 y) and 46 568 individuals in the non–PLS group (70.6% male; median age, 44 y) received a positive HCV-RNA test result. Significantly more individuals from the PLS group than the non–PLS group were linked to treatment (83% vs 51%) and initiated treatment (73% vs 33%; both
<jats:italic toggle="yes">P</jats:italic>
< .001). Among those with a treatment outcome, 75% in the PLS group versus 80% in the non–PLS group achieved a sustained virologic response (SVR) (
<jats:italic toggle="yes">P</jats:italic>
< .001). Significantly more individuals achieved SVR among those receiving a positive HCV-RNA test result in the PLS group than in the non–PLS group (36% vs 11%;
<jats:italic toggle="yes">P</jats:italic>
< .001).
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusion:</jats:title>
<jats:p>A key strength in peer-led models lies in linkage to treatment when compared with drug services alone. This finding highlights the importance of ongoing support for peer-led programs helping medically underserved populations living with HCV progress to treatment and achieve elimination.</jats:p>
</jats:sec>
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