A 31-year-old male with a 10-year history of injection drug use presents to a community clinic with persistent fatigue for 3-4 months, unexplained weight loss (~5kg over 6 months), and intermittent right upper quadrant abdominal discomfort. In his medical history, a history of injection drug use (heroin) beginning at age 20 was reported. He is currently using injection drugs approximately 3-4 times weekly, sharing equipment occasionally. He refers limited access to sterile injection equipment in his area due to a lack of local harm reduction policies.

Laboratory tests show altered aminotransferase values and positivity for anti-HCV, and subsequently HCV RNA positivity. He is hence diagnosed with HCV infection, presumably chronic, and his liver fibrosis assessment by VCTE suggests at least F2 (moderate) fibrosis. The patient expresses interest in both HCV treatment and substance use disorder services.