Elimination of Hepatitis C Virus Among Users of Substances

Study Overview
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Brief Summary
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Substance users are a vulnerable group that should be prioritized in HCV (Hepatitis C Virus) elimination efforts in Mexico and in which it is feasible to carry out micro-elimination programs. It is an important group to treat both because of its high prevalence and because of the dynamic spread of infection among the general population. HCV seropositivity has not been documented in this group of people in Mexico City, the metropolitan area and the northern states of the country, nor has the sustained viral response been evaluated in this group of patients in the Mexican population.

Detailed Description
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The investigators would use a work team, the program and the value proposal would be presented to the local authorities, the coordinator of the national commission against dependencies and doctors. The investigators would use an algorithm designed for the first-step diagnosis of HCV in SUs (Substances Users) , and defined the key centers for screening and linking to care. The project is planned as follows: Screening: SUs in centers of substance users in Mexico City, the metropolitan area and states in the North of the country will be evaluated with rapid tests. Those with a positive result will be selected. Diagnosis: Patients with a positive rapid test result will undergo a viral load test against HCV. Those with positive results will be selected. Link-up: Those who are confirmed positive will be profiled to receive treatment at INCMNSZ. they will receive damage reduction to prevent reinfection or primary infection in negatives (granted by the rehabilitation center). Treatment: The treatment will be received in a certified hospital (INCMNSZ) to treat patients with HCV infection, the treatment will be indicated by doctors who work in this hospital in the treatment consultations for hepatitis C or in centers with substance users with doctors trained to administer the treatment. This training will be received by telementoring. And also during the treatment, follow-up will be given with telementoring sessions if necessary. This group of people has personality characteristics that require a integral treatment, so it will be a integral and multidisciplinary treatment with psychological care and harm reduction (provided by the rehabilitation center) Confirm SVR: A viral load test will be performed 12 weeks after the end of treatment to corroborate SVR. They will be given after this a mentorship for harm reduction and advice against reinfections The importance of this project is characterized by minimal monitoring, patients and doctors education by telementoring, multidisciplinary teams and integral treatment

Official Title
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Eliminación de la infección Por el Virus de la Hepatitis C en PWID en Los Estados Del Norte de México

Conditions
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Hepatitis C in Substance Users

Intervention / Treatment
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* Drug: Sofosbuvir 400 MG / Velpatasvir 100 MG [Epclusa]


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients older than 18 years. Active infection by hepatitis C virus. People who use substances and who are users of rehabilitation centers in Mexico City, the metropolitan area and the northern states of the country. Signature of informed consent Exclusion Criteria: all those who do not fit the inclusion criteria

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Substances Users<br>Substances users confirmed with Viral Load for HCV. after that will be evaluated through laboratory studies (CBC and blood chemistry), HIV/HBV (Hepatitis B Virus) serology, fibrosis status will be evaluated through APRI (AST to Platelet Ratio Index) and FIB-4. The antiviral treatment (sofosbuvir/Velpatasvir) will be chosen according to the characteristics of each patient and follow-up will be maintained according to the national plan with a visit at the end of treatment and 12 weeks after its end to assess SVR. The importance of this project is characterized by minimal monitoring, patients and doctors education by telementoring, multidisciplinary teams and integral treatment. | Drug: Sofosbuvir 400 MG / Velpatasvir 100 MG [Epclusa]<br>* 1 tab every 24 hrs for 12 weeks<br>* Other names: Epclusa;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sustained viral response (SVR) in people who use substances in the Mexico City metropolitan area and the northern states of the country. | Number por participants who achive SVR whit the treatment | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Seroprevalence and prevalence of HCV in people who use substances in the Mexico City metropolitan area and the northern states of the country. | Number of participants with chronic HCV infection | through study completion, an average of 1 year | 
| No Sustained viral response (SVR) in people who use Substances in the Mexico City | Number of participants who does not achive RVS | through study completion, an average of 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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HCV, Elimination, Substance Users