Increases in Hepatitis C Virus (HCV) Treatment and Cure Among People Who Inject Drugs in the Seattle Area Between 2018 and 2022.

This study aimed to describe the current hepatitis C virus (HCV) continuum of care and characterize the prevalence of HCV among Seattle-area people who inject drugs (PWID), including an assessment of changes between 2018 and 2022. Cross-sectional data from the 2018 and 2022 Seattle-area National HIV Behavioral Surveillance (NHBS) surveys of PWID was included in this study. All participants completed a biobehavioral survey and were offered rapid HIV and HCV antibody testing. Among those who screened HCV antibody-positive, we estimated proportions for steps along the HCV care continuum, including proportions of PWID who had previously been told they had HCV, were treated, and cured. The 2018 and 2022 NHBS-PWID surveys included 533 and 495 participants, respectively. In 2022, 61% (303/495) of PWID tested HCV antibody-positive, compared with 71% (376/533) in 2018. Among those who were HCV antibody-positive, prior HCV testing was common in both years [94% (95% CI: 91%-96%) in 2018; 92% (95% CI: 89%-95%) in 2022]. The proportion reporting prior HCV diagnosis increased from 68% (95% CI: 63%-72%) in 2018 to 71% (95% CI: 66%-76%) in 2022. Among those diagnosed, treatment rose from 26% (95% CI: 20%-31%) in 2018 to 47% (95% CI: 40%-54%) in 2022, and cure increased from 18% (95% CI: 14%-23%) in 2018 to 33% (95% CI: 27%-40%) in 2022. Compared to 2018, in 2022 the proportion of PWID with HCV in the Seattle area who had been treated and cured nearly doubled. Sustained investment in HCV diagnosis and treatment is needed to strengthen the HCV continuum of care.