# Integrating HCV services into HIV programs for PWID in India

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2020 · $1,123,856

## Abstract

7. PROJECT SUMMARY / ABSTRACT
As access to antiretroviral therapy (ART) has expanded and people live longer with HIV, HCV mortality has
increased. The burden is particularly high in people who inject drugs (PWID). However, HCV can be cured with
highly efficacious medications resulting in calls for microelimination. In settings with key population-focused
HIV epidemics, microelimination may be achieved by integrating HCV services with existing HIV and harm
reduction services to simultaneously improve HIV and HCV outcomes. Our team has successfully scaled
integrated care centers (ICCs) for PWID across India. ICCs provide vertically integrated, HIV prevention and
treatment services in stand-alone stigma-free venues. We integrated HCV point-of-care testing in 2015 and
demonstrated significant improvements in HCV testing and awareness. However, HCV treatment remains a
missing component. Accordingly, we investigate the impact of the integration of HCV treatment with individually
tailored treatment support into 7 PWID focused ICCs. Our Aims are to: Aim 1: Evaluate whether individual
treatment outcomes in HCV mono- and HIV/HCV co-infected PWID can be optimized by tailoring treatment
support in 7 PWID-focused integrated HIV/HCV prevention/treatment centers. Subaim 1A: Compare sustained
virologic response (SVR) in PWID undergoing DAA-based HCV therapy randomized by a “precision clinical
trial” approach to varying levels (low, medium, high) of treatment support tailored to need using an algorithm
based on factors associated with early HIV viral suppression. Subaim 1B: Estimate the incidence of HCV-
reinfection by HIV status among PWID achieving SVR. Subaim 1C: Evaluate the impact of HCV cure on HIV
viral suppression among HIV/HCV co-infected PWID. Aim 2: Characterize barriers and facilitators to
integration of HCV treatment with tailored treatment support and HIV services through a mixed-methods
evaluation to facilitate implementation in other settings. Aim 3: Estimate population-level effectiveness and
cost-effectiveness of integrating HCV testing and treatment with essential HIV prevention and treatment
services. Subaim 3A: Assess the observed and future impact of integrated HCV/HIV testing and treatment on
chronic HCV and HIV prevalence and incidence among PWID using epidemic modeling and serosurvey data.
Subaim 3B: Evaluate the cost-effectiveness of integrated HCV/HIV testing and treatment and identify the most
cost-effective HCV treatment support strategies. To achieve these aims, we will scale on-site HCV testing and
treatment in 7 ICCs across India that already deliver essential HIV services to ~10,000 PWID. Treatment
support will be personalized using an algorithm based on early HIV viral suppression to triage clients into two
strata: minimal and elevated risk for failure. Using a novel unbalanced randomization approach, we will assess
efficacy of low (self-administered), medium (peer navigator) and high intensity (DOT) treatment support
strategies ...

## Key facts

- **NIH application ID:** 9974478
- **Project number:** 5R01AI145555-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Shruti H Mehta
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,123,856
- **Award type:** 5
- **Project period:** 2019-07-08 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9974478

## Citation

> US National Institutes of Health, RePORTER application 9974478, Integrating HCV services into HIV programs for PWID in India (5R01AI145555-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9974478. Licensed CC0.

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