Intervention – standard HCV treatment
infectious diseases, infectious disease
INFECTIOUS DISEASES, INFECTIOUS DISEASE, DISORDERS
Participants in the standard HCV treatment group were referred to the centralized outpatient infectious disease clinic at the collaborating referral hospital for HCV treatment. An appointment was given and usually scheduled within a few weeks after the referral; the participants were informed of this by mail. Their clinical assessment could involve additional blood samples and imaging before initiating HCV treatment. In the first year of the study, HCV consultation with a consultant in infectious diseases was mandatory, but with increasing clinical experience and growing evidence, the primary assessment became voluntary. Participants were offered follow-up assessments, including blood samples, during treatment in the infectious disease outpatient clinic every four weeks as well as a posttreatment assessment 12 weeks after completion. This typically involved a total of 4 to 5 consultation visits at the outpatient clinic. They were responsible for retrieving and adhering to their prescriptions, and attending assessment appointments. At 12 weeks after the end of treatment (EOT12), blood samples, including HCV polymerase chain reaction, were drawn at infectious disease outpatient clinics, OAT clinics, and CCCs. In addition, participants met at OAT clinics or CCCs to assess their FSS-9 levels.In the standard HCV treatment, participants needed to travel to the hospital clinic and pay for the transport themselves, a distance that ranged from 1 to 25 km. They received standard follow-up in the OAT clinic for drug use disorders, and all other types of care – apart from HCV care – were integrated into the OAT follow-up. The OAT site staff encouraged participants to visit the infectious disease hospital clinics, but no further extensive follow-up was performed. There was a risk that scheduled appointments may overlap with other activities such as receiving OAT medication and other drug use treatment, since arrangements were not coordinated.