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COMMUNITY CASE STUDY article

Front. Med.
Sec. Hepatobiliary Diseases
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1429516

Experience and Challenges Delivering Hepatitis C Virus Treatment for People Who Inject Drugs in Kenya

Provisionally accepted
Joyce Boke Joyce Boke 1Aliza Monroe-Wise Aliza Monroe-Wise 2Grace Umutesi Grace Umutesi 3Loice Mbogo Loice Mbogo 1Betsy Sambai Betsy Sambai 1David E. Bukusi David E. Bukusi 4Bhavna Chohan Bhavna Chohan 2John Scott John Scott 2Esther Gitau Esther Gitau 5Bill Sinkele Bill Sinkele 5Helgar Musyoki Helgar Musyoki 6Joshua Herbeck Joshua Herbeck 3Carey Farquhar Carey Farquhar 3Brandon L. Guthrie Brandon L. Guthrie 2*
  • 1 Global Assistance Program-Kenya, University of Washington, Nairobi, Kenya, Nairobi, Kenya
  • 2 University of Washington, Seattle, Washington, United States
  • 3 Department of Global Health, University of Washington, Seattle, Washington, United States
  • 4 Kenyatta National Hospital, Nairobi, Kenya
  • 5 Support for Addiction Prevention and Treatment in Africa(SAPTA), Nairobi, Kenya, Nairobi, Kenya
  • 6 Global fund kenya, Nairobi, Kenya

The final, formatted version of the article will be published soon.

    Despite having a higher risk of hepatitis C virus (HCV) infections, people who inject drugs (PWID) in sub-Saharan Africa (SSA) have limited access to HCV treatment. There is scarce literature on treatment delivery modalities that overcome logistical and financial barriers. We utilized different service delivery modalities to providedirect-acting antivirals (DAAs) to PWIDs infected with HCV through methadone clinics and needle and syringe program (NSP) sites in Kenya. In collaboration with Kenya's National AIDS and STI Control Programme (NASCOP), we enrolled individuals with active HCV infection confirmed by HCV RNA detection from methadone and NSP sites in Nairobi, Mombasa, and Kilifi counties. Liver function and hepatitis B virus (HBV) status were assessed at baseline. Those eligible for treatment were offered ledipasvir-sofosbuvir treatment provided by NASCOP through directly observed therapy (DOT). Participants completed a follow-up visit 12 weeks after completing treatment to measure sustained viral response (SVR-12). Challenges faced while delivering HCV treatment at participating sites included the limited availability and reliability of laboratory assays, and financial constraints faced by PWIDs to attend daily DOT. Based on our experience, strategies to deliver HCV treatment for PWID in Kenya should consider improving the availability of laboratory tests and prioritizing treatment through methadone centers to achieve good outcomes.

    Keywords: hepatitis C virus (HCV), People who inject drugs (PWIDs), Kenya, sub-Saharan Africa, and HCV Treatment

    Received: 09 May 2024; Accepted: 10 Oct 2024.

    Copyright: © 2024 Boke, Monroe-Wise, Umutesi, Mbogo, Sambai, Bukusi, Chohan, Scott, Gitau, Sinkele, Musyoki, Herbeck, Farquhar and Guthrie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Brandon L. Guthrie, University of Washington, Seattle, 98195-4550, Washington, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.