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We aimed to evaluate HCV RNA prevalence, liver disease burden, linkage to care and treatment uptake and outcomes among people attending a homelessness service in Sydney. Participants were enrolled in an observational cohort study with recruitment at a homelessness service over eight liver health campaign days. Finger\u2010stick whole\u2010blood samples for Xpert\u00ae HCV Viral Load and venepuncture blood samples were collected. Participants completed a self\u2010administered survey and received transient elastography and clinical assessment by a general practitioner or nurse. Clinical follow\u2010up was recommended 2\u201012\u00a0weeks after enrolment. For participants initiating direct\u2010acting antiviral (DAA) therapy, medical records were audited retrospectively and treatment outcome data were collected. Among 202 participants (mean age, 48\u00a0years), 82% were male (n\u00a0=\u00a0165), 39% (n\u00a0=\u00a078) reported ever injecting drugs, of whom 63% (n\u00a0=\u00a049) injected in the previous month. Overall, 23% (n\u00a0=\u00a047) had detectable HCV RNA and 6%\u00a0(n=12) had cirrhosis. HCV RNA prevalence among participants with either injecting or incarceration history was 35% (37\/105), compared to 4% (3\/73) among participants without these risk factors. Among those with detectable HCV RNA, 23 (49%) commenced therapy, of whom 65% (n\u00a0=\u00a015) achieved sustained virological response, while the remainder had no available treatment outcome. No participant had documented virological failure. HCV DAA treatment uptake among people attending a homelessness service was encouraging, but innovative models of HCV care are required to improve linkage to care and treatment uptake among this highly marginalized population.<\/jats:p>","DOI":"10.1111\/jvh.13112","type":"journal-article","created":{"date-parts":[[2019,4,13]],"date-time":"2019-04-13T16:08:05Z","timestamp":1555171685000},"page":"969-979","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Hepatitis C virus testing, liver disease assessment and direct\u2010acting antiviral treatment uptake and outcomes in a service for people who are homeless in Sydney, Australia: The LiveRLife homelessness study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2663-3845","authenticated-orcid":false,"given":"Sahar","family":"Bajis","sequence":"first","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1833-2017","authenticated-orcid":false,"given":"Jason","family":"Grebely","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Cooper","sequence":"additional","affiliation":[{"name":"Matthew Talbot Hostel St Vincent de Paul Society NSW Support Services Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Smith","sequence":"additional","affiliation":[{"name":"Matthew Talbot Hostel St Vincent de Paul Society NSW Support Services Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg","family":"Owen","sequence":"additional","affiliation":[{"name":"Matthew Talbot Hostel St Vincent de Paul Society NSW Support Services Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Chudleigh","sequence":"additional","affiliation":[{"name":"Matthew Talbot Hostel St Vincent de Paul Society NSW Support Services Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-2028","authenticated-orcid":false,"given":"Behzad","family":"Hajarizadeh","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9444-0186","authenticated-orcid":false,"given":"Marianne","family":"Martinello","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Adey","sequence":"additional","affiliation":[{"name":"NSW Users and AIDS Association Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5422-3777","authenticated-orcid":false,"given":"Phillip","family":"Read","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Gilliver","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanya","family":"Applegate","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8230-0386","authenticated-orcid":false,"given":"Carla","family":"Treloar","sequence":"additional","affiliation":[{"name":"Centre for Social Research in Health UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Maher","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory J.","family":"Dore","sequence":"additional","affiliation":[{"name":"The Kirby Institute UNSW Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,5,2]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.WHO Global Hepatitis Report 2017.Geneva:WHO;2017. 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