Hepatitis C virus testing and treatment among HIV-infected people who inject drugs in St. Petersburg, Russia

Aims: The HIV epidemic in the Russian Federation, driven by injection drug use, is among the fastest growing in the world. Hepatitis C virus (HCV) infection is highly prevalent among people who inject drugs (PWID). Although treatment for HCV has been low among PWID, with newer therapies it may become possible to provide treatment to prevent complications and reduce transmission in this population. The study aim was to describe the current frequency of HCV testing and treatment in a cohort of HIV-infected PWID in St. Petersburg, Russia. Methods: This study used baseline data from the “Linking Infectious and Narcology Care” (LINC) study, a randomized controlled trial of an intervention to link HIV-infected PWID hospitalized at a narcology hospital with HIV medical care. Participants were 18- 70 years old, HIV-infected, and had a history of injection drug use. Descriptive statistics were performed to assess the frequency of HCV screening and treatment. Results: Participants (n = 263) had a mean age 33.7 (SD±4.9) years, 26% female, 100% Caucasian, 54% unemployed and 14% married/ partnered. Median years since HIV diagnosis was 6.3 (IQR: 4-11). Median CD4 cell count was 315 (IQR: 161-491) and only 5.3% had ever been on anti-retroviral therapy. In the past month, 86% had used heroin and 23% reported sharing works. Nearly all participants had been screened for HCV (259/263; 98.5%), and all screened reported that they were positive. Only 4 participants (2%) reported ever receiving HCV treatment. Conclusions: Among HIV-infected PWID hospitalized for opioid dependence in St. Petersburg, Russia, nearly all reported being screened for HCV and testing positive, while only 2% had received treatment. Substantial opportunities exist in narcology hospitals for eradicating HCV in HIV-infected Russian IDUs.