What have we achieved so far?

In WS1 we have treated over 600 PWID in NHS Tayside within drug treatment services, pharmacy, needle exchange and prison. This rapid scale-up of HCV treatment among PWID has advanced overall progress on HCV elimination. By the end of 2019, NHS Tayside had diagnosed an estimated 90% of all those HCV infected and treated 90% of those diagnosed, potentially meeting the World Health Organization’s 2030 HCV elimination target 11 years early.
We hypothesised that scale-up of HCV treatment in Tayside would reduce chronic HCV in PWID to ~10%; this is an approximate 2/3 reduction in chronic HCV and provisional estimates show this has been achieved.
Retrospective and prospective testing of samples from the Needle Exchange Surveillance Initiative (NESI) sweeps in Scotland show that scale-up of DAA treatment among PWID can be achieved through HCV testing and treatment in community drug services whilst maintaining high sustained virologic responses (SVR) and is associated with reduction in chronic HCV in the population https://doi.org/10.1111/add.15459.
In WS3 we have interviewed service users and providers in NHS Tayside to identify key barriers and facilitators that can help other sites successfully scale-up HCV treatment.  We have also conducted stakeholder events with Scottish health boards, third sector organisations and Operational Delivery Networks within NHS England to gain their insights. The final recommendations for scaling up HCV testing and treatment for People Who Inject Drugs can be found here: Set of Recommendations (PDF, 883kB)Set of Recommendations (PDF, 883kB) ‌
In England, HCV testing has been completed on stored samples from 2011-2018. Evidence suggests there has been a small reduction in HCV viraemia among antibody-positive PWID in England since 2016, concomitant with DAA scale-up, and some indication that treatment access has improved in the same period https://onlinelibrary.wiley.com/doi/pdf/10.1111/jvh.13575.