C-FREE-2 Protocol 4.0 for sustainability

C-FREE-1 study was conducted from May 2019 to March 2023. In April 2023, C-FREE-2 was launched. The objectives and design remain comparable, but we now use a new combination of hepatitis C treatment called Sofosbuvir/Ravidasvir as the core treatment option.

However, as the Thai national treatment program no longer incorporates drug use as an exclusion criterion, in April 2025, the C-FREE-2 consortium launched protocol amendment 4.0, adapting procedures to also study the applicability and effectiveness of integrating hepatitis C treatment provided by the national program through the C-FREE community services. Some partner hospitals provide medicines from the national program for treatment at the community centers. At certain sites, participants can also elect to seek treatment from the national program in hospitals, and we aim to compare treatment uptake and outcomes of different treatment approaches. Training of all sites' research nurses, research assistants, and study physicians were organized between March 14–21, 2025, and procedures are now ongoing.