Model of Care

People who inject drugs are most at risk for acquiring hepatitis C. In Thailand, studies among people who inject drugs (PWID) have shown that up to 80-90% of them have been infected with the virus. Breakthrough therapy now exists to cure hepatitis C, but uptake is low because of costs barriers, and PWID are often denied treatment.

 

The C-FREE Study is the first community-based model of care in Thailand for diagnosis and treatment of hepatitis C in PWID, using

a highly-effective novel treatment combination called sofosbuvir/velpatasvir. The study is based at drop-in centers (DIC) run by partner organizations (APASS, Care Team, Give Hope, Ozone, Raks Thai Foundation, TDN, Together). Testing for HCV, but also hepatitis B and HIV are all done at the DIC by trained research nurses. Care and support are provided for all participants who test positive for HBV and HIV. For eligible participants with HCV, physicians give treatment with sofosbuvir/velpatasvir through weekly clinics at the DIC. Participants who are cured are monitored for reinfection and provided support to stay HCV-free.

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The C-FREE community based model of care has already shown early success, driving many people to come to access services.

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Some participants have come from far distances in Thailand

to receive friendly care and treatment services.

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Essentially all participants who have completed treatment have been confirmed to be cured from HCV infection. 

How it works

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1. Partner NGOs disseminate information
about the C-FREE treatment opportunity
to people who use drugs, in the community. 
2. A Research Nurse in the community 
drop-in-center (DIC) provides counselling
and testing of Hepatitis C, B and HIV.
3. People with confirmed Hepatitis C infection
meet a study doctor who provides & monitors curative treatment of Hepatitis C, at the DIC
weekly clinic.
4. 12 weeks after completion of treatment,
the Research Nurse confirms cure of 
the infection with rapid viral load testing
done on site.
 

Our future plans

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Include and cure more people in need at the current C-FREE study sites.

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Open a new study site in Tak province, and 3 other sites in Bangkok, in Dec 2021