# Informing hepatitis C virus elimination strategies with epidemiological data from highest need populations

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $188,405

## Abstract

ABSTRACT
 First available in 2014, direct-acting antivirals (DAAs) are a highly effective and well-tolerated curative
therapy for people infected with hepatitis C virus (HCV) and offer the first real opportunity to achieve HCV
elimination. The availability of DAAs alone, however, is not translating to widespread treatment initiation among
marginalized groups living with HCV, particularly those engaged in illicit drug use. Achieving HCV elimination
requires a concerted public health response that must be directed through evidence-based decision-making
focused on how best to reduce the burden in the most-impacted subgroups.
 To address this need, we propose to generate new Continuum of Care (CoC) estimates and evidence-
based elimination roadmaps – two essential tools to achieve elimination – that include current needs of key
high-risk subgroups who bear the greatest burden of disease: young people who inject drugs, men who have
sex with men and inject drugs, and transgender women. In collaboration with End Hep C SF – a new collective
action consortium of public health, academic, and community advocates in San Francisco – our research team
established the first citywide HCV seroprevalence estimate in 2016 for San Francisco's general population,
overall and by broadly define risk groups (e.g., young people who inject drugs and men who have sex with
men).
 In this R21, we propose to again partner with End Hep C SF to apply a multi-method epidemiological
approach to estimate the population of these 3 high-risk subgroups at four stages of the CoC: (1) screened
chronic infection, (2) RNA-confirmed infection, (3) DAA treatment engaged, and (4) cured and identify key
determinants of CoC stage drop-off (Aim 1). These CoC data will allow for parameterization of new epidemic
models that evaluate the impact of various scenarios of efforts to improve CoC proportions within each
subgroup, identifying combinations of strategies that could achieve elimination (Aim 2). In collaboration with
our partners in End Hep C SF, we will conduct a series of iterative consensus meetings with diverse experts to
adapt modeling projections to create evidence-based elimination roadmaps that include annual intervention
targets and benchmarks that are context-specific and feasible given programmatic realities in San Francisco
(Aim 3). These elimination roadmaps will respond to identified needs and barriers to address gaps along each
CoC, while also ensuring realistic benchmarks to achieve elimination targets. Doing so will be replicable in
other cities, enhancing current NIH research dollars invested in these subgroups and laying the groundwork for
subsequent R01 applications to test specific evidence-based HCV interventions.!

## Key facts

- **NIH application ID:** 9973066
- **Project number:** 5R21DA046809-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Meghan D Morris
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $188,405
- **Award type:** 5
- **Project period:** 2019-07-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9973066

## Citation

> US National Institutes of Health, RePORTER application 9973066, Informing hepatitis C virus elimination strategies with epidemiological data from highest need populations (5R21DA046809-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9973066. Licensed CC0.

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