Background: Liver disease burden among people who inject drugs (PWID) is high. The aim of this study was to assess factors associated with severe fibrosis/cirrhosis and follow-up among PWID participating in a liver health promotion campaign.

Methods: LiveRLife involved: (i) educational resource development; (ii) resource testing; and (iii) implementation. Between May and October 2014, participants were enrolled in an observational study with recruitment from four clinics in Australia (one community-based primary health care clinic, two opioid substitution treatment clinics and one medically supervised injecting centre). Participants received educational material, clinical assessment, transient elastography (TE) assessment, dried-blood spot testing (including hepatitis C virus ribonucleic acid [HCV RNA] testing) and knowledge survey.

Results: Of 253 participants (mean age = 43, 68% male), 71% had injected in the past month, and 68% were HCV RNA+. Overall, 68% had no/mild fibrosis (F0/F1, ≥2.5 – ≤7.4 kPa), 13% moderate fibrosis (F2, ≥7.5 – ≤9.4 kPa), 10% severe fibrosis (F3, ≥9.5 – ≤12.4 kPa), and 9% had cirrhosis (F4, ≥12.5 kPa). The proportion of people with severe fibrosis/cirrhosis (F3/F4, 19%) was higher in those who were >50 years (33% vs. 15%, P = 0.003), male (23% vs. 11%, P = 0.069), and those HCV RNA+ (24% vs. 10%, P = 0.011). In adjusted analysis, age >50 years (OR 2.91, 95%CI, 1.42, 5.95) and being HCV RNA+ (OR 2.61, 95%CI, 1.08, 6.28) were associated with severe fibrosis/cirrhosis (F3/F4). Sixty percent (n = 152) returned for a follow-up nurse/specialist assessment.

Conclusion: Liver disease burden in this population was high, but the majority returned for follow-up assessment, supporting the inclusion of TE in HCV-related care.

Disclosure of Interest Statement: The study was supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. The Kirby Institute is funded by the Australian Government Department of Health and Ageing. The views expressed in this publication do not necessarily represent the position of the Australian Government. GD is supported by a National Health and Medical Research Council Practitioner Research Fellowships. JG is supported by a National Health and Medical Research Council Career Development Fellowship. SJ is supported by an Australian Research Council Future Fellowship.