Lessons learned from a hepatitis C testing, case management and linkage to care program for persons who inject drugs from metropolitan Chicago

The Chicago Hepatitis C (HCV) Testing, Case Management and Linkage to Care Program (HepCLink) provided HCV testing, case management and linkage to medical care for persons who inject drugs (PWID) in metropolitan Chicago, Illinois, U.S.A. In year 1, we screened 1,005 PWID for HCV antibodies (67% male; 43% non-Hispanic (NH) black, 31% NH-white, 22% Hispanic, 4% other; 52% uninsured). Of the 20% (n=204) who were HCV antibody-positive, 77 (38%) followed-through with HCV viral load testing; 84% (n=65) of whom were chronically infected. A novel HCV-focused case management program was developed in year 1 to address treatment initiation barriers among PWID. Most participants reported multiple barriers (e.g. unstable housing, uninsured) that required an extensive period (i.e. >1 year) to address prior to treatment readiness. Lessons learned during year 1 of HepCLink have informed strategic revisions in years 2-3 that have improved testing uptake, follow-up and treatment readiness outcomes.