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When performed in people who use drugs (PWUD), it is mainly focused on those receiving opiate agonist therapy (OAT). We wanted to reach out to a population of difficult to reach PWUD not on centralized OAT, using non-invasive screening as a bridge to re-integration in medical care supported by facilitated referral to a specialist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, multicenter cohort study in PWUD not enrolled in a centralized OAT program in a community-based facility in Limburg or OAT program in a community-based facility in Antwerp, Belgium, from October 2018 until October 2019. Two study teams recruited participants using an outreach method at 18 different locations. Participants were tested for HCV antibodies (Ab) by finger prick, and risk factors were assessed through a face-to-face questionnaire. Univariate analyses were used to assess the association between HCV Ab and each risk factor separately. A generalized linear mixed model was used to investigate the association between the different risk factors and HCV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 425 PWUD were reached with a mean age of 41.6\u2009\u00b1\u200910.8, and 78.8% (335\/425) were men. HCV Ab prevalence was 14.8% (63\/425). Fifty-six (88.9%) PWUD were referred, of whom 37 (66.1%) were linked to care and tested for HCV RNA. Twenty-nine (78.4%) had a chronic HCV infection. Treatment was initiated in 17 (58.6%) patients. The adjusted odds for HCV Ab were highest in those with unstable housing 6\u00a0months before inclusion (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001, AOR 8.2 CI 95% 3.2\u201323.3) and in those who had ever shared paraphernalia for intravenous drug use (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001, AOR 6.2 CI 95% 2.5\u201316.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An important part tested positive for HCV. Treatment could be started in more than half of the chronically infected referred and tested positive for HCV-RNA. Micro-elimination is necessary to achieve the World Health Organization goals by 2030. However, it remains crucial to screen and link a broader group of PWUD to care than to focus solely on those who inject drugs.<\/jats:p><jats:p><jats:italic>Trial registration<\/jats:italic>: clinicaltrials.gov NCT04363411, Registered 27 April 2020\u2014Retrospectively registered.<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04363411?term=NCT04363411&amp;draw=2&amp;rank=1\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04363411?term=NCT04363411&amp;draw=2&amp;rank=1<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1186\/s12954-021-00502-7","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T20:04:41Z","timestamp":1621281881000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Identification and treatment of viral hepatitis C in persons who use drugs: a prospective, multicenter outreach study in Flanders, Belgium"],"prefix":"10.1186","volume":"18","clinical-trial-number":[{"clinical-trial-number":"nct04363411","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0887-4119","authenticated-orcid":false,"given":"Dana","family":"Busschots","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9cile","family":"Kremer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob","family":"Bielen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6zg\u00fcr Muhammet","family":"Koc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leen","family":"Heyens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eefje","family":"Dercon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Verrando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa","family":"Windelinckx","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Griet","family":"Maertens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Bourgeois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niel","family":"Hens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catharina","family":"Mathe\u00ef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geert","family":"Robaeys","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"key":"502_CR1","unstructured":"WHO: Global Hepatitis Report, 2017. 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The study protocol is registered at clinicaltrials.gov (NCT04363411). The study was conducted in accordance with the provisions of the Declaration of Helsinki and its amendments. Good clinical practice guidelines were followed throughout the study and all participants provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"D.B. has received travel grants from AbbVie and Gilead Sciences and research grants from Gilead; R.B. has received travel grants from AbbVie, Gilead Sciences, and MSD and research grants from Gilead and MSD; \u00d6.K. has received a travel grant and research grants from Gilead and CyTuVax BV; N.H. has received grants from GlaxoSmithKline (GSK), grants from Johnson & Johnson pharmaceuticals and grants from Pfizer; C.M has received travel grants from Gilead, MSD Belgium, and INDIVIOR and has acted as consultant for MSD Belgium; G.R. has received research grants from AbbVie, Janssen Pharmaceuticals, MSD, and has acted as a consultant\/advisor for AbbVie, BMS, Gilead Sciences, and MSD. All other co-authors report no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"54"}}