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In 2015, an estimated 71 million people worldwide were chronically infected with hepatitis C virus (HCV). Since the introduction of direct-acting antivirals (DAAs) in 2013, HCV elimination has become achievable. The WHO aims to eliminate viral hepatitis as a public health threat by 2030. However, this remains challenging in remote areas of low- and middle-income countries (LMICs), where access to HCV viral load testing and treatment is limited.
HCV viral load testing is essential for identifying patients needing DAA treatment and for assessing treatment success. To expand testing in remote areas, the WHO recommends using dried blood spots (DBS) for easier sample transport. Additionally, DAA access must be extended beyond urban centers.
Vietnam has high HCV prevalence, especially among people who inject drugs (PWID) and people living with HIV (PLHIV).
This prospective cohort study in remote Vietnam compares adherence to 12-week DAA treatment between PWID and non-PWID. Secondary outcomes include treatment success, genotyping, and re-infection monitoring. DBS will be used for viral load testing at a central lab in Hanoi. Patients receive generic Sofosbuvir and Daclatasvir (WHO pre-qualified) and are followed for 30 months. In case of treatment failure, metagenomic analysis is performed to study HCV variants.
