352 – Point-Of-Care Hepatitis C Screening and Open Access Clinic Improves Linkage to Care and Treatment Uptake Among Ex Drug Users Population in Singapore: A Cluster Randomized Study

People who inject drugs (PWID) and other marginalized populations with high hepatitis C virus (HCV) infection rates represent a unique challenge for treatment initiation due to health, administrative and social barriers. We analyzed the HCV cascade of care (CoC) in some vulnerable subpopulations in Madrid, Spain, when using a mobile point of care. to identify gaps and barriers to improve HCV elimination efforts in these populations. Methods: From 2019 to 2021, a mobile unit was used to screen for HCV using a linkage-to-care and two-step point-of-care-based strategy. Viremic participants were grouped into four subgroups: PWID, homeless individuals, people with a mental health disorder (MHD) and people with alcohol use disorder (AUD). Logistic regression and Cox and Aalen’s additive models were used to analyze associated factors and differences between groups. Results: A prospectively recruited cohort of 214 HCV infected individuals (73 PWID, 141 homeless, 57 with a MHD and 91 with AUD) participated in the study. The overall HCV CoC analysis found that: 178 (83.1%) attended a hospital, 164 (76.6%) initiated direct-acting antiviral therapy and 141 (65.8%) completed therapy, of which 99 (95.2%) achieved a sustained virological response (SVR). PWID were significantly less likely to initiate treatment, while individuals with AUD waited longer before starting treatment. Both people with AUD and PWID were significantly less likely to complete HCV treatment. Conclusions: Overall, SVR was achieved in the majority of the participants treated. However, PWID need better linkage to care and treatment, while PWID and AUD need more support for treatment completion.

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Hepatitis C testing and linkage to care among adults on probation in a large US city

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab636 ◽

2021 ◽

Author(s):

Kevin F Kamis ◽

David L Wyles ◽

Matthew S Minturn ◽

Tracy Scott ◽

Dean McEwen ◽

...

Keyword(s):

Hepatitis C ◽

Point Of Care ◽

Linkage To Care ◽

Virologic Response ◽

Patient Navigator ◽

Hcv Rna ◽

Study Cohort ◽

Hcv Treatment ◽

Hiv Test ◽

Hcv Testing

Abstract Background Despite constituting the largest segment of the correctional population, individuals on probation remain largely unstudied with respect to hepatitis C virus (HCV) testing and linkage-to-care. We implemented an HCV testing and patient navigation program at an adult probation department. Methods Adults were tested at a local probation department with a rapid point-of-care HCV antibody (Ab) assay followed by a lab-based HCV RNA assay if anti-HCV positive. All individuals received counseling rooted in harm-reduction principles. Individuals testing positive for HCV Ab were immediately linked to a patient navigator in person or via telephone. The patient navigator assisted patients through cure unless lost to follow-up. Study participation involved an optional survey and optional point-of-care HIV test. Results Of 417 individuals tested, 13% were HCV Ab positive and 65% of those tested for HCV RNA (34/52) had detectable HCV RNA. Of the 14 individuals who linked to an HCV treatment provider, 4 completed treatment as measured by pharmacy fill documentation in the electronic medical record, and 1 obtained sustained virologic response. 193 individuals tested for HIV; none tested positive. Conclusions The study cohort had a higher HCV seroprevalence than the general population (13% vs 2%), but linkage-to-care, completion of HCV treatment, and successful test-of-cure rates were all low. This study indicates that HCV disproportionately impacts adults on probation and prioritizing support for testing and linkage-to-care could improve health in this population. Co-localization of HCV treatment within probation programs would reduce the barrier of attending a new institution and could be highly impactful.

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THU-167-Prevalence, linkage to care and treatment of hepatitis C virus in person who inject drugs under opioid substitution therapy in a Spanish area

Journal of Hepatology ◽

10.1016/s0618-8278(19)30442-6 ◽

2019 ◽

Vol 70 (1) ◽

pp. e235-e236

Author(s):

Ylenia Pérez Castaño ◽

Alexandra Gomez Garcia ◽

Jose Manuel Chouza Pérez ◽

Vanesa Sanz Largo ◽

Sandra Arranz Diaz ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Linkage To Care ◽

Substitution Therapy ◽

Opioid Substitution Therapy ◽

Care And Treatment ◽

Opioid Substitution

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Risk Factors Associated with Linkage to Care among Suburban Hepatitis C-Positive Baby Boomers and Injection Drug Users

Infectious Diseases and Therapy ◽

10.1007/s40121-019-0249-y ◽

2019 ◽

Vol 8 (3) ◽

pp. 417-428 ◽

Cited By ~ 2

Author(s):

Audun J. Lier ◽

Kalie Smith ◽

Kerim Odekon ◽

Silvia Bronson ◽

Erin Taub ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C ◽

Baby Boomers ◽

Injection Drug Users ◽

Drug Users ◽

Linkage To Care ◽

Injection Drug ◽

Factors Associated

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Overcoming Barriers to Prevention, Care, and Treatment of Hepatitis C in Illicit Drug Users

Clinical Infectious Diseases ◽

10.1086/427441 ◽

2005 ◽

Vol 40 (s5) ◽

pp. S276-S285 ◽

Cited By ~ 142

Author(s):

Brian R. Edlin ◽

Thomas F. Kresina ◽

Daniel B. Raymond ◽

Michael R. Carden ◽

Marc N. Gourevitch ◽

...

Keyword(s):

Hepatitis C ◽

Drug Users ◽

Illicit Drug ◽

Illicit Drug Users ◽

Care And Treatment

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Hepatitis C Rapid Point-of-Care Testing and Laboratory-based Non-invasive Assessment of Liver Fibrosis among Drug Abusers: An Experience from Iran

Archives of Iranian Medicine ◽

10.34172/aim.2021.14 ◽

2021 ◽

Vol 24 (2) ◽

pp. 94-100

Author(s):

Mohammad Reza Hedayati-Moghaddam ◽

Hossein Soltanian ◽

Majid Danaee ◽

Seyed Ahmad Vahedi

Keyword(s):

Hepatitis C ◽

Liver Fibrosis ◽

Drug Treatment ◽

Drug Users ◽

Point Of Care ◽

Rapid Test ◽

Hcv Infection ◽

Point Of Care Testing ◽

Non Invasive ◽

Test Kit

Background: People who use drugs, particularly injection drug users (IDUs) are known as the major source of hepatitis C virus (HCV) infection. This study was performed to determine the prevalence of HCV infection using rapid point-of-care testing and to assess liver fibrosis by non-invasive lab tests among addict populations of Mashhad, Iran. Methods: In this cross-sectional study, drug users who referred to drug treatment and harm reduction centers of Mashhad were enrolled during March and December 2019. A rapid test kit was used to assess the presence of anti-HCV antibodies and a real-time PCR was performed to confirm the infection. The AST-platelet ratio index (APRI) and fibrosis-4 (FIB-4) score were used to investigate liver fibrosis in patients with positive HCV RNA. A P value <0.05 was considered as significant. Results: A total of 390 drug users aged 15–74 years were assessed. Sixty-four individuals showed positive results for anti-HCV (16.4%), of whom 58 blood samples were available for PCR test. The viremic rate among the latter group was calculated at 84.5% (49/58); the total viremia prevalence was 12.8% (49/384). Multivariate analysis revealed that being single (P = 0.040) or divorced/ widow (P = 0.011) and history of drug injection (P<0.001) and tattoos (P = 0.021) were significantly associated with current HCV infection. Using APRI and FIB-4 indices, significant liver fibrosis was identified in 14.3% and 18.4% of cases, respectively. Conclusion: HCV infection screening using rapid tests and examining liver fibrosis by non-invasive lab tests appear to be practicable and useful among poor populations in settings such as drug treatment centers.

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