Avramovic, GordanaReilly, MaeveCullen, WalterMacías, JuanMcCombe, GeoffMcHugh, TinaOprea, CristianaStory, AlistairSurey, JulianSabin, CarolineBivegete, SandraVickerman, PeterWalker, JosephineWard, ZoeLambert, John S2023-02-092023-02-092020-09-28http://hdl.handle.net/10668/16343Hepatitis C Virus (HCV) is a significant cause of chronic liver disease. Among at-risk populations, access to diagnosis and treatment is challenging. We describe an integrated model of care, Hepcare Europe, developed to address this challenge. Using a case-study approach, we describe the cascade of care outcomes at all sites. Cost analyses estimated the cost per person screened and linked to care. A total of 2608 participants were recruited across 218 clinical sites. HCV antibody test results were obtained for 2568(98•5%); 1074(41•8%) were antibody-positive, 687(60•5%) tested positive for HCV-RNA, 650(60•5%) were linked to care, and 319(43•5%) started treatment. 196(61•4%) of treatment initiates achieved a Sustained Viral Response (SVR) at dataset closure, 108(33•9%) were still on treatment, eight (2•7%) defaulted from treatment, and seven (2•6%) had virologic failure or died. The cost per person screened varied from €194 to €635, while the cost per person linked to care varied from €364 to €2035. Hepcare enhanced access to HCV treatment and cure, and costs were affordable in all settings, offering a framework for scale-up and reproducibility.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Cascade of careHCV eliminationHepatitis CIntegrated HCV carePeople who inject drugs (PWID)System of careVulnerable populationsAntiviral AgentsCitiesDelivery of Health CareDisease EradicationEuropeHepacivirusHepatitis CHumansMiddle AgedReproducibility of ResultsVulnerable Populationsresearch article32992012open access10.1016/j.ijid.2020.09.14451878-3511http://www.ijidonline.com/article/S1201971220321615/pdf