Successful Cascade of Care and Cure HCV in 5382 Drugs Users: How Increase HCV Treatment by Outreach Care, Since Screening to Treatment

Introduction In France 33% of patients didn’t take care of hepatitis C because there were no diagnosed. Drug injection was main contamination route of hepatitis C virus (HCV) in France. French guidelines were to treat all inmates and drug users, even fibrosis level. Access of HCV screening, care and treatment in drugs users, prisoners and homeless was low in France. They were considered as difficult to treat populations. All these patients need specific support. Hepatitis Mobile Team (HMT) was created in July 2013 to increase screening care and treatment of hepatitis B and C patients. HMT was composed of hepatologist, nurses, social workers and health care worker. Objective increase outreach screening care treatment access and cure of our target population. Patients and methods Target population was drugs users, prisoners, homeless, precarious people, migrants and psychiatric patients. We proposed part or all of our services to our 42 medical and social partners: HCV HBV screening by DBS (dried blood test); outside DBS and FIBROSCAN in converted van; Outreach open center; Drug users information and prevention, Free blood tests in primary care;, Staff training; Social screening and diagnosis; Mobile liver stiffness Fibroscan in site; Advanced on-site specialist consultation; Easy access to pre-treatment commission; Low cost mobile phones for patients; Individual psycho-educative intervention sessions; Collective educative workshops; Peer to peer educational program; Specific one day hospitalizations. All services were free for patients and for partners. Results from 2013 July to 2018 December, we did 8382 DBS for 5382 people (3053 HCV DBS) and 2302 Fibroscan*. HCV new positive rate was 21.3%. Our HCV active file was 651patients included these 24.8% new patients screened by DBS; 98% realized HCV genotype, HCV viral load and FIBROSCAN. DAA treatment was proposed to 96%; 95% started treatment, 4% were lost follow up or refused treatment. After treatment, there was 7 relapse and 3 reinfections by drug injection and cured rate of 94%. Sociological evaluation showed that 4 program qualities for patients: free access, closeness (outside hospital), speed (of the results) and availability (of nurse and social workers). Conclusions: Specific follow-up of drugs users and other HCV high-risk patients including screening, early detection, diagnosis and treatment increase rate of treated and cured patients, with low rate of relapse and reinfections.

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Sentinel laboratory surveillance of hepatitis C antibody testing in England: understanding the epidemiology of HCV infection

Epidemiology and Infection ◽

10.1017/s0950268806006832 ◽

2006 ◽

Vol 135 (3) ◽

pp. 417-426 ◽

Cited By ~ 23

Author(s):

L. J. BRANT ◽

M. HURRELLE ◽

M. A. BALOGUN ◽

P. KLAPPER ◽

F. AHMAD ◽

...

Keyword(s):

Hepatitis C ◽

Drug Users ◽

Laboratory Data ◽

National Surveillance ◽

Antibody Testing ◽

Specific Patient ◽

Laboratory Surveillance ◽

Patient Groups ◽

Test Result

This paper describes sentinel laboratory surveillance of hepatitis C antibody testing in England. Demographic and test result data were supplemented by follow-up questionnaires sent to the requesting clinician. Between October 2002 and September 2003 almost 75000 anti-HCV tests were performed in eight sentinel centres. More males were tested than females and over half of those tested were aged 25–44 years. Overall 5·7% (3333/58144, range 2·8–7·7%) individuals tested positive. Follow-up questionnaire data showed that 82% (1043/1277) of the positives had injecting drug use reported as the main risk exposure. The majority of negative individuals were undergoing routine screening as recommended for specific patient groups. Most individuals were asymptomatic. Antibody prevalence was estimated to be 34% in current injecting drug users and 42% in former injectors. Comparing positives to routine national surveillance suggests that only 53% (1782/3333) of diagnosed cases were reported. Sentinel laboratory data can provide valuable supplementary data to national surveillance.

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Follow-Up for Medical Care Among Drug Users With Hepatitis C

Evaluation & the Health Professions ◽

10.1177/0163278706296003 ◽

2006 ◽

Vol 29 (4) ◽

pp. 355-366 ◽

Cited By ~ 10

Author(s):

Grace L. Reynolds ◽

Dennis G. Fisher ◽

Adi Jaffe ◽

Jordan Edwards

Keyword(s):

Hepatitis C ◽

Medical Care ◽

Drug Users

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Assessment and medical follow-up of intravenous drug users (IVDU) positive for hepatitis C virus (HCV) in North East England

Hepatology ◽

10.1016/0270-9139(95)95261-6 ◽

1995 ◽

Vol 22 (4) ◽

pp. A385 ◽

Cited By ~ 1

Author(s):

A BRIND

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Drug Users ◽

Intravenous Drug ◽

Intravenous Drug Users ◽

North East

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"The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2006000400024 ◽

2006 ◽

Vol 22 (4) ◽

pp. 861-870 ◽

Cited By ~ 14

Author(s):

Maria de Lourdes Aguiar Oliveira ◽

Mariana A. Hacker ◽

Sabrina Alberti Nóbrega de Oliveira ◽

Paulo Roberto Telles ◽

Kycia Maria Rodrigues do Ó ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Injection Drug Users ◽

Rio De Janeiro ◽

Drug Users ◽

Illicit Drugs ◽

Drug Injection ◽

Hepatitis C Infection ◽

Public Places ◽

Hcv Transmission

The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus) infection were investigated. Injection drug users (IDUs) (N = 606) were recruited in "drug scenes" (public places, bars) in Rio de Janeiro, Brazil, interviewed, and tested for HCV. Sharing of needles/syringes was more prevalent at the first injection (51.3%) than at the baseline interview (36.8%). Those who shared syringes/needles at first injection were more likely to be currently engaged in direct/indirect sharing practices. Among young injectors (< 30 years), those reporting sharing of needles/ syringes at the first injection were about four times more likely to have been infected by HCV. Hepatitis C virus prevalence among active IDUs (n = 272) was 11%. Prison history and longer duration of drug injection were identified as independent predictors of HCV infection. To effectively curb HCV transmission among IDUs and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs.

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