Harm reduction-based and peer-supported hepatitis C treatment for people who inject drugs in Georgia

Georgia faces high HCV rates (5.4% of chronic cases in general population) with an epidemic concentrated among people who inject drugs (PWID). A National HCV Elimination Program (NHCEP), was launched in April 2015, aiming to eliminate HCV by 2020. To succeed, this program must develop tailored interventions to enroll PWID in treatment.We implemented a pilot intervention to facilitate access to and retention of PWID in the NHCEP, and to prevent reinfection after treatment. Screening was offered at a harm reduction center. PWID with positive results were followed by peer-workers during medical assessment, which lasted 73days in average, and throughout the treatment by Sofosbuvir and Ribavirin+/- PegInterferon for 12, 24 or 48 weeks delivered at a medical center. Additional prevention sessions and PCR checks were delivered to PWID 6 and 12 months after the confirmation of sustained virologic response.The pilot intervention screened 554 people in 5 months with 244 starting treatment. The majority of participants (98.0%, n=239) completed the treatment. The intervention, initially implemented in the capital, was replicated in a rural area.Peer-supported and strongly integrated, comprehensive HCV care will help PWID reach high uptake and adherence to care.