A recent study conducted in Iran examined the hepatitis C virus (HCV) cascade of care (CoC) and factors influencing engagement among people who inject drugs (PWID). Using respondent-driven sampling across 14 cities, 2,308 PWID were surveyed to assess their HCV testing and treatment history. The study revealed that only 23.1% of PWID had ever been tested for HCV, with a mere 3.4% testing positive for HCV antibodies and 2.5% receiving a diagnosis. Among those diagnosed, 54.4% initiated treatment, and 31.6% achieved sustained virologic response (SVR). The study identified several factors associated with higher rates of HCV antibody testing, including knowledge of HCV transmission, living with HIV, receiving needle exchange programs, and opioid agonist treatment.

The findings highlight a significant gap in engagement within the HCV CoC for PWID in Iran. The study emphasizes the need to enhance access to HCV testing services, particularly for PWID who face challenges such as limited awareness of HCV transmission and structural barriers. Improving testing access is seen as a crucial first step in HCV elimination efforts, which would be vital for strengthening the response to HCV in Iran, especially among high-risk populations.

Reference: Khezri M, Tavakoli F, Mehmandoost S, et al. Engagement in hepatitis C virus cascade of care and factors associated with testing among people who inject drugs in Iran. Harm Reduct J. 2025 Apr 8;22(1):49. doi: 10.1186/s12954-025-01162-7. PMID: 40200230; PMCID: PMC11977883.