Background

An estimated 1.07 million people in Vietnam are infected with the Hepatitis C virus (HCV). We recently embarked on a major research collaboration with the Hospital for Tropical Diseases (HTD) in Ho Chi Minh City to address this epidemic.

The South-East Asian Research Collaborative in Hepatitis (SEARCH) launched a 600-patient cohort study and two clinical trials, both investigating shortened treatment strategies for chronic HCV infection with direct-acting antiviral drugs. ‘SEARCH-1’, a 103-patient pilot study, began enrolling patients in February 2019. ‘VIETNARMS’, a 1092-patient multi-arm randomized controlled trial funded by a Wellcome collaborative award, commenced enrollment in 2020.

To date, these studies have recruited from populations already engaged in care at the HTD. Participants are aware of HCV infection and its implications and are well-motivated to seek treatment. People who inject drugs (PWID) and commercial sex workers are under-represented. In the ‘VIETNARMS trial, we are investigating the efficacy of treatment strategies that could be used to treat underserved populations (e.g. ultrashort or intermittent therapy). Should these strategies have efficacy as hoped, it will be crucial to develop innovative ways to engage with these ‘hard-to-reach’ populations.

We propose a ‘bottom-up’ approach using community-based participatory research (CBPR) to explore barriers to accessing HCV care and determine actions to improve engagement.

We received a seed award to conduct stakeholder mapping of organizations working with underserved populations at high risk of HCV within Vietnam.

Injecting drug use is associated with the highest rates of HCV, and it is estimated that between 50-90% of PWID in Vietnam have HCV. We started the seed award work in March 2020 by collaborating with organizations focused on PWID, with the aim of expanding to other underserved, high-risk populations. Based on the results of the stakeholder mapping, we also formed two working groups to advise us on the conduct of the study.

Secondary Aims

1. Integrate CBPR-developed questions and solutions into future operational research questions
2. Increase CBPR capacity building in underserved communities, with local advisory groups, for continued local engagement and expansion into other regional contexts.