Hepatitis C Treatment Initiation During Hospitalization for People Who Use Drugs: A Narrative Review of the Literature

People who use drugs (PWUD) are increasingly acquiring and transmitting hepatitis C virus (HCV) and being admitted to the hospital for often costly non-HCV-related conditions. Traditionally, treatment of HCV has been deferred to the outpatient setting. However, outpatient HCV follow-up can be an arduous process to navigate with resultant gaps in care, especially for PWUD with numerous complex psychosocial and medical comorbidities. Hospitalization presents a key opportunity to initiate treatment, and several institutions have piloted inpatient treatment models with intensive outreach. We conducted a narrative review of peer-reviewed literature (2014-2024) evaluating hospital-based HCV treatment models for PWUD; 6 studies from 4 countries met inclusion criteria. Evidence suggests that engaging PWUD during hospitalization leads to higher treatment initiation and completion as compared with standard-of-care outpatient referral. Inpatient HCV treatment models should be one part of a comprehensive plan in the United States and internationally to eliminate HCV for all.