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Objective: To evaluate the feasibility of testing and treating people who inject drugs at a supervised injecting facility for hepatitis C virus (HCV) infection. Design: Retrospective cohort study. Setting, participants: People who inject drugs who attended the Melbourne supervised injecting facility, 30 June 2018 – 30 June 2020. Main outcome measures: Proportion of people tested for hepatitis C; proportions of people positive for anti‐HCV antibody and HCV RNA, and of eligible people prescribed direct‐acting antiviral (DAA) treatment; sustained virological response twelve weeks or more after treatment completion. Results: Of 4649 people who attended the supervised injecting facility during 2018–20, 321 were tested for hepatitis C (7%); 279 were anti‐HCV antibody‐positive (87%), of whom 143 (51%) were also HCV RNA‐positive. Sixty‐four of 321 had previously been treated for hepatitis C (20%), 21 had clinically identified cirrhosis (7%), eight had hepatitis B infections (2%), and four had human immunodeficiency virus infections (1%). In multivariate analyses, people tested for hepatitis C were more likely than untested clients to report psychiatric illness (adjusted odds ratio [aOR], 9.65; 95% confidence interval [CI], 7.26–12.8), not have a fixed address (aOR, 1.59; 95% CI, 1.18–2.14), and to report significant alcohol use (aOR, 1.57; 95% CI, 1.06–2.32). The median number of injecting facility visits was larger for those tested for hepatitis C (101; interquartile range [IQR], 31–236) than for those not tested (20; IQR, 3–90). DAA treatment was prescribed for 126 of 143 HCV RNA‐positive clients (88%); 41 of 54 with complete follow‐up data were cured (76%). Conclusions: People who attend supervised injecting facilities can be tested and treated for hepatitis C on site. Models that provide streamlined, convenient hepatitis C care promote engagement with treatment in a group in which the prevalence of hepatitis C is high. [ABSTRACT FROM AUTHOR]

Background Following a HIV outbreak among Aboriginal people in a culturally diverse inner-city suburb of Melbourne, a blood-borne virus (BBV) screening program was conducted to inform public health interventions to prevent transmission and facilitate timely diagnosis and linkage to care.Methods: In August-September 2014, community health workers recruited people who inject drugs (PWID) from a local needle and syringe program. Participants were tested for hepatitis C virus (HCV), hepatitis B virus (HBV), HIV and syphilis and completed a bio-behavioural questionnaire.Results: In total, 128 PWID participated in the study. Serological evidence of exposure to HCV and HBV was detected among 118 (93%) and 57 participants (45%) respectively. Five participants were HIV positive. Independent risk factors for needle sharing were Aboriginality (AOR=6.21, P<0.001), attending health care for mental health problems (AOR=2.79, P=0.023) and inability to access drug treatment in the previous 6 months (AOR=4.34, P=0.023).Conclusions: BBV prevalence in this sample was much higher than reported in other recent Australian studies. This local population is at high risk of further BBV transmission, particularly Aboriginal PWID. Individual and service-related factors associated with risk in the context of a dynamic urban drug culture and HIV outbreak suggest an urgent need for tailored harm-reduction measures. [ABSTRACT FROM AUTHOR]