Hepatitis C: Community Testing and Treatment (CT2)

The CT2 Study examined the feasibility, acceptability, effectiveness and cost-effectiveness of a community-based testing and treatment program for hepatitis C (HCV).

Objective

This study aimed to assess the feasibility, acceptability, effectiveness, and cost-effectiveness of decentralized community-based POC testing and DAA therapy for hepatitis C among people who inject drugs and the general population in Yangon, Myanmar.

Study design

This was a feasibility study with two sites:

• Thingangyun Key Population Service Centre (Burnet Institute, serving people who inject drugs primarily), No.63B, Ground Floor, Yadanar Thukha Street, Thingangyun Township, Yangon
• Than Sitt Charity Liver Clinic – 1 Yangon (Myanmar Liver Foundation, serving general population), No.33-35, Ground Floor, Pathein Street, Sanchaung Township, Yangon.

Study inclusion criteria

• aged ≥18 years
• attendance at study site
• willing and able to provide written informed consent.

Study exclusion criteria

• confirmed HCV RNA positive result (chronic HCV infection) prior to study recruitment
• treatment experienced (either DAA or pegylated interferon)
• HBV infected
• HIV infected
• eGFR <30
• active tuberculosis (if known active tuberculosis or as per symptom screening assessment)
• pregnant women
• serious drug-drug interaction with sofosbuvir/daclatasvir, or a drug that the patient is unwilling or unable to stop taking.
• patients with confirmed HCV RNA positive results received standard of care in Myanmar. This involved receiving services provided through the government testing and treatment program or through philanthropic services providing testing and treatment.

Timeline

January 2019–September 2020.

Approach

Ethical considerations

The study protocol, site-specific informed consent forms, recruitment materials, as well as any subsequent modifications, are approved by Department of Medical Research Institutional Review Board in Myanmar and Alfred Ethics Committee in Melbourne.

Written informed consent was obtained from every study participant.

Publication

The results was submitted for publication in peer-reviewed journals and abstracts submitted for relevant conference presentations. No identifying information from study participants was included in any publications, reports or presentations. Results presented only contained aggregate data.

Results

The results of this study  informed any potential scale-up of community-based primary care provision of hepatitis C services in Myanmar and other resource-constrained settings.

Results from the CT2 Study were presented at the EASL ILC Virtual Event in August 2020. The summary findings were presented to key stakeholders at the dissemination workshop in October 2020. The Summary Report is now available online on this page.

Community impact