Among people who inject drugs (PWID), WHO hepatitis C virus (HVC) elimination targets are unlikely to be met without 3-monthly RNA/cAg testing accompanied by other prevention measures, a recent study suggests. Researchers determined the testing frequencies (2-yearly, annually, 6-monthly and 3-monthly) and retention in care required among PWID to achieve the HCV incidence reduction target through treatment as prevention in low (25%), medium (50%), and high (75%) chronic HCV prevalence settings. They found:

• In low-prevalence settings, 2-yearly antibody testing of PWID was estimated to reach the elimination target by 2027-2030 depending on retention in care, with annual testing reducing the time by up to 3 years.
• In medium-prevalence settings, if close to 90% testing coverage were achieved, then annual antibody testing with at least 70% retention in care or annual HCV RNA/cAg testing would be required.
• In high-prevalence settings, even 3-monthly HCV RNA/cAg testing of PWID was unable to achieve the incidence reduction target and may need other prevention measures to meet the goal.