{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:14:02Z","timestamp":1792502042358,"version":"4.5.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse of the National Institutes of Health","doi-asserted-by":"publisher","award":["UH3DA044831"],"award-info":[{"award-number":["UH3DA044831"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hepatitis C virus (HCV) elimination requires treating people who use drugs (PWUD), yet &amp;lt;10% of PWUD in the United States access HCV treatment; access is especially limited in rural communities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We randomized PWUD with HCV viremia and past 90-day injection drug or nonprescribed opioid use in 7 rural Oregon counties to peer-assisted telemedicine HCV treatment (TeleHCV) versus peer-assisted referral to local providers (enhanced usual care [EUC]). Peers supported screening and pretreatment laboratory evaluation for all participants and facilitated telemedicine visits, medication delivery, and adherence for TeleHCV participants. Generalized linear models estimated group differences in HCV viral clearance (primary outcome) and HCV treatment initiation and completion (secondary outcomes).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 203 randomized participants (100 TeleHCV, 103 EUC), most were male (62%), White (88%), with recent houselessness (70%), and used methamphetamines (88%) or fentanyl\/heroin (58%) in the past 30 days. Eighty-five of 100 TeleHCV participants (85%) initiated treatment versus 13 of 103 (12%) EUC participants (relative risk [RR], 6.7 [95% confidence interval {CI}, 4.0\u201311.3]; P &amp;lt; .001). Sixty-three of 100 (63%) TeleHCV participants versus 16 of 103 (16%) EUC participants achieved viral clearance 12 weeks after anticipated treatment completion date (RR, 4.1 [95% CI: 2.5\u20136.5]; P &amp;lt; .001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The Peer TeleHCV treatment model substantially increased HCV treatment initiation and viral clearance compared to EUC. Replication in other rural and low-resource settings could further World Health Organization HCV elimination goals by expanding and decentralizing treatment access for PWUD.<\/jats:p>\n                  <jats:p>Clinical Trials Registration. NCT04798521.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae520","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T18:27:51Z","timestamp":1732732071000},"page":"501-508","source":"Crossref","is-referenced-by-count":26,"title":["Peer-Assisted Telemedicine for Hepatitis C in People Who Use Drugs: A Randomized Controlled Trial"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8955-6210","authenticated-orcid":false,"given":"Andrew","family":"Seaman","sequence":"first","affiliation":[{"name":"Section of Addiction Medicine, Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Cook","sequence":"additional","affiliation":[{"name":"Section of Addiction Medicine, Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Leichtling","sequence":"additional","affiliation":[{"name":"Comagine Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan C","family":"Herink","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Oregon State University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonhi","family":"Gailey","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Cooper","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunter C","family":"Spencer","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Babiarz","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Fox","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Thomas","sequence":"additional","affiliation":[{"name":"Oregon Health Authority"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith M","family":"Leahy","sequence":"additional","affiliation":[{"name":"Health Systems Division, Behavioral Health Services, Oregon Health Authority , Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica E","family":"Larsen","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5556-3597","authenticated-orcid":false,"given":"P Todd","family":"Korthuis","sequence":"additional","affiliation":[{"name":"Section of Addiction Medicine, Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health & Science University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"key":"2025031715502572200_ciae520-B1","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/S2468-1253(22)00386-7","article-title":"Global reporting of progress towards elimination of hepatitis B and hepatitis C","volume":"8","author":"Cui","year":"2023","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025031715502572200_ciae520-B2","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.15585\/mmwr.mm7132e1","article-title":"Vital signs: hepatitis C treatment among insured adults\u2014United States, 2019\u20132020","volume":"71","author":"Thompson","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025031715502572200_ciae520-B3","doi-asserted-by":"crossref","first-page":"399","DOI":"10.15585\/mmwr.mm6914a2","article-title":"Vital signs: newly reported acute and chronic hepatitis C cases\u2015United States, 2009\u20132018","volume":"69","author":"Ryerson","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025031715502572200_ciae520-B4","doi-asserted-by":"crossref","first-page":"e955","DOI":"10.1093\/cid\/ciac175","article-title":"Sustained impact of the coronavirus disease 2019 pandemic on hepatitis C virus treatment initiations in the United States","volume":"75","author":"Hoenigl","year":"2022","journal-title":"Clin Infect Dis"},{"key":"2025031715502572200_ciae520-B5","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1111\/liv.14634","article-title":"Hepatitis C treatment uptake among people who inject drugs in the oral direct-acting antiviral era","volume":"40","author":"Falade-Nwulia","year":"2020","journal-title":"Liver Int"},{"key":"2025031715502572200_ciae520-B6","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1093\/cid\/ciu643","article-title":"Emerging epidemic of hepatitis C virus infections among young nonurban persons who inject drugs in the United States, 2006\u20132012","volume":"59","author":"Suryaprasad","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2025031715502572200_ciae520-B7","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.amepre.2020.08.031","article-title":"Changing urban\u2013rural disparities in the utilization of direct-acting antiviral agents for hepatitis C in US Medicare patients, 2014\u20132017","volume":"60","author":"Du","year":"2021","journal-title":"Am J Prev Med"},{"key":"2025031715502572200_ciae520-B8","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s11904-018-0393-0","article-title":"Challenges facing a rural opioid epidemic: treatment and prevention of HIV and hepatitis C","volume":"15","author":"Schranz","year":"2018","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2025031715502572200_ciae520-B9","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1001\/jama.2023.3692","article-title":"A national hepatitis C elimination program in the United States: a historic opportunity","volume":"329","author":"Fleurence","year":"2023","journal-title":"JAMA"},{"key":"2025031715502572200_ciae520-B10","doi-asserted-by":"crossref","DOI":"10.3386\/w31139","volume-title":"Projected health benefits and health care savings from the United States National Hepatitis C Elimination Initiative","author":"Chhatwal","year":"2023"},{"key":"2025031715502572200_ciae520-B11","doi-asserted-by":"crossref","first-page":"e2115523","DOI":"10.1001\/jamanetworkopen.2021.15523","article-title":"Association of the extension for community healthcare outcomes project with use of direct-acting antiviral treatment among US adults with hepatitis C","volume":"4","author":"Tran","year":"2021","journal-title":"JAMA Network Open"},{"key":"2025031715502572200_ciae520-B12","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.cgh.2020.09.011","article-title":"Ehealth technologies for screening, diagnosis, and management of viral hepatitis: a systematic review","volume":"19","author":"Haridy","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025031715502572200_ciae520-B13","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1093\/cid\/ciy899","article-title":"Integrated, co-located, telemedicine-based treatment approaches for hepatitis C virus management in opioid use disorder patients on methadone","volume":"69","author":"Talal","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2025031715502572200_ciae520-B14","doi-asserted-by":"crossref","first-page":"103917","DOI":"10.1016\/j.drugpo.2022.103917","article-title":"Interventions to enhance testing and linkage to treatment for hepatitis C infection for people who inject drugs: a systematic review and meta-analysis","volume":"111","author":"Cunningham","year":"2023","journal-title":"Int J Drug Policy"},{"key":"2025031715502572200_ciae520-B15","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/ADM.0000000000000810","article-title":"Peer recovery support services across the continuum: in community, hospital, corrections, and treatment and recovery agency settings\u2014a narrative review","volume":"16","author":"Stack","year":"2022","journal-title":"J Addict Med"},{"key":"2025031715502572200_ciae520-B16","doi-asserted-by":"crossref","first-page":"103982","DOI":"10.1016\/j.drugpo.2023.103982","article-title":"Single-visit hepatitis C point-of-care testing, linkage to nursing care, and peer-supported treatment among people with recent injecting drug use at a peer-led needle and syringe program: the TEMPO pilot study","volume":"114","author":"Grebely","year":"2023","journal-title":"Int J Drug Policy"},{"key":"2025031715502572200_ciae520-B17","doi-asserted-by":"crossref","first-page":"103959","DOI":"10.1016\/j.drugpo.2023.103959","article-title":"Predictors of hepatitis C cure among people who inject drugs treated with directly observed therapy supported by peer case managers in Kenya","volume":"113","author":"Akiyama","year":"2023","journal-title":"Int J Drug Policy"},{"key":"2025031715502572200_ciae520-B18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12916-019-1300-2","article-title":"Improving engagement with healthcare in hepatitis C: a randomised controlled trial of a peer support intervention","volume":"17","author":"Stagg","year":"2019","journal-title":"BMC Med"},{"key":"2025031715502572200_ciae520-B19","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/S2468-1253(21)00471-4","article-title":"Interventions to enhance testing, linkage to care, and treatment initiation for hepatitis C virus infection: a systematic review and meta-analysis","volume":"7","author":"Cunningham","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025031715502572200_ciae520-B20","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/bjs.1800600817","article-title":"Transection of the oesophagus for bleeding oesophageal varices","volume":"60","author":"Pugh","year":"1973","journal-title":"Br J Surg"},{"key":"2025031715502572200_ciae520-B21","first-page":"53","article-title":"Estimating the size of hidden populations using snowball sampling","volume":"10","author":"Frank","year":"1994","journal-title":"J Off Stat"},{"key":"2025031715502572200_ciae520-B22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13722-023-00384-z","article-title":"A randomized controlled trial for a peer-facilitated telemedicine hepatitis C treatment intervention for people who use drugs in rural communities: study protocol for the \u201cpeer tele-HCV\u201d study","volume":"18","author":"Herink","year":"2023","journal-title":"Addict Sci Clin Pract"},{"key":"2025031715502572200_ciae520-B23","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"2025031715502572200_ciae520-B24","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jhep.2016.04.030","article-title":"Factors associated with spontaneous clearance of chronic hepatitis C virus infection","volume":"65","author":"Bulteel","year":"2016","journal-title":"J Hepatol"},{"key":"2025031715502572200_ciae520-B25","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified Poisson regression approach to prospective studies with binary data","volume":"159","author":"Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"2025031715502572200_ciae520-B26","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1016\/j.jhep.2023.12.020","article-title":"Optimal hepatitis C treatment adherence patterns and sustained virologic response among people who inject drugs: the HERO study","volume":"80","author":"Heo","year":"2024","journal-title":"J Hepatol"},{"key":"2025031715502572200_ciae520-B27","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/jrh.12614","article-title":"Disparities in digital access among American rural and urban households and implications for telemedicine-based services","volume":"38","author":"Curtis","year":"2022","journal-title":"J Rural Health"},{"key":"2025031715502572200_ciae520-B28","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1111\/jrh.12737","article-title":"Substance use disorder treatment and technology access among people who use drugs in rural areas of the United States: a cross-sectional survey","volume":"39","author":"Button","year":"2023","journal-title":"J Rural Health"},{"key":"2025031715502572200_ciae520-B29","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/jvh.13662","article-title":"Hepatitis C treatment outcomes among people who inject drugs accessing harm reduction settings in Kenya","volume":"29","author":"Akiyama","year":"2022","journal-title":"J Viral Hepat"},{"key":"2025031715502572200_ciae520-B30","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/S2468-1253(18)30304-2","article-title":"Direct-acting antiviral treatment for hepatitis C among people who use or inject drugs: a systematic review and meta-analysis","volume":"3","author":"Hajarizadeh","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025031715502572200_ciae520-B31","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1001\/jamainternmed.2022.0170","article-title":"Accessible hepatitis C care for people who inject drugs: a randomized clinical trial","volume":"182","author":"Eckhardt","year":"2022","journal-title":"JAMA Intern Med"},{"key":"2025031715502572200_ciae520-B32","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1089\/tmj.2018.0161","article-title":"Patient reaction to telemedicine for clinical management of hepatitis C virus integrated into an opioid treatment program","volume":"25","author":"Talal","year":"2019","journal-title":"Telemed J E Health"},{"key":"2025031715502572200_ciae520-B33","doi-asserted-by":"crossref","first-page":"594","DOI":"10.7326\/M18-1715","article-title":"Intensive models of hepatitis C care for people who inject drugs receiving opioid agonist therapy: a randomized controlled trial","volume":"170","author":"Akiyama","year":"2019","journal-title":"Ann Intern Med"},{"key":"2025031715502572200_ciae520-B34","doi-asserted-by":"crossref","first-page":"ofac225","DOI":"10.1093\/ofid\/ofac225","article-title":"Rapid treatment initiation for hepatitis C in young people who inject drugs: the seek, test, and rapid treatment randomized trial","volume":"9","author":"Eckhardt","year":"2022","journal-title":"Open Forum Infect Dis"},{"key":"2025031715502572200_ciae520-B35","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.jhep.2019.11.012","article-title":"Hepatitis C reinfection after successful antiviral treatment among people who inject drugs: a meta-analysis","volume":"72","author":"Hajarizadeh","year":"2020","journal-title":"J Hepatol"},{"key":"2025031715502572200_ciae520-B36","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1093\/cid\/ciad127","article-title":"Hepatitis C virus reinfection in a real-world cohort of homeless-experienced individuals in Boston","volume":"77","author":"Beiser","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2025031715502572200_ciae520-B37","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/S2468-1253(22)00275-8","article-title":"Patient-centred models of hepatitis C treatment for people who inject drugs: a multicentre, pragmatic randomised trial","volume":"7","author":"Litwin","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025031715502572200_ciae520-B38","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1111\/liv.14043","article-title":"Disparities in uptake of direct-acting antiviral therapy for hepatitis C among people who inject drugs in a Canadian setting","volume":"39","author":"Soc\u00edas","year":"2019","journal-title":"Liver Int"},{"key":"2025031715502572200_ciae520-B39","author":"Oregon ECHO Network"},{"key":"2025031715502572200_ciae520-B40","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s12879-024-09124-3","article-title":"Overreporting of adherence to hepatitis C direct-acting antiviral therapy and sustained virologic response among people who inject drugs in the HERO study","volume":"24","author":"Lopes","year":"2024","journal-title":"BMC Infect Dis"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciae520\/61189134\/ciae520.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/3\/501\/61189134\/ciae520.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/3\/501\/61189134\/ciae520.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T15:51:05Z","timestamp":1742226665000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/80\/3\/501\/7909503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,17]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,12,17]]},"published-print":{"date-parts":[[2025,3,17]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciae520","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,3,15]]},"published":{"date-parts":[[2024,12,17]]}}}