198. Highway to Health: Mobile Pharmacy and Clinic Providing Hepatitis C Testing and Treatment

TL;DR

A mobile clinic offering hepatitis C testing and treatment successfully reached vulnerable populations and improved access to care.

Contribution

The study introduces a mobile healthcare model that reduces barriers to hepatitis C testing and treatment in community settings.

Findings

The mobile clinic identified 5 new hepatitis C infections among 171 individuals who accepted rapid testing.

40.7% of those with hepatitis C had an undetectable viral load, indicating potential treatment success.

Only 37.5% of individuals with detectable viral load initiated treatment, highlighting ongoing challenges in follow-up.

Abstract

People who use substances face barriers when seeking treatment for hepatitis C (HCV). In 2023, the first Mobile Pharmacy and Clinic (MPC) was launched, staffed by a clinician, community health care workers, a phlebotomist, and a pharmacist. It aims to reduce barriers and initiate HCV treatment in non-stigmatizing community setting.

Between December 2023 and March 2025, persons receiving primary whole person health care on an MPC which offered free rapid HCV testing. Those with positive results were offered on-site confirmatory testing and treatment. Clinical data were collected to assess access, acceptability, and outcomes.

Of the 578 persons who engaged in care on the MPC, 53% were male, 43% Hispanic, 47% identified as White, had a median age of 49 years, 44% had unstable or no housing, and 20% have an opioid use disorder. HCV infection was previously diagnosed in 59 (10.2%), and for those without a previous diagnosis, 32.9% (n=171) accepted rapid HCV testing which identified 5 (2.9%) new infections. Of the 64 with HCV, 2 (3.0%) had recently been tested and found to have an undetectable viral load (VL), and 42.2% (n=27) underwent VL testing, with 11 (40.7%) being found to have an undetectable VL.

Of the 16 with detectable VL, 6 (37.5%) did not initiate treatment (3 were referred to a specialist for cirrhosis evaluation, 1 is pending a follow-up appointment to start treatment, and 2 were lost to follow-up). Ten were initiated on DAA treatment, with1 still receiving treatment and 9 have completed treatment. Of the 9 that having completed treatment: 2 have achieved 12-week SVR, 4 are awaiting 12-week SVR testing, and 3 have completed treatments but were unable to get 12-week SVR confirmation due to transfer of services or being lost to follow-up.

A mobile healthcare model can improve HCV testing and treatment outcomes for vulnerable persons at a community level.

Sheela Shenoi, MD MPH, Merck and Company, Inc.: My spouse worked for Merck 1997-2007 and retains stock in his retirement account. There is no conflict of interest, but included for full disclosure.