Theme: Models of Care Year: 2019
BACKGROUND:
Persons who inject drugs, homeless people, people with alcohol abuse and sex workers are
vulnerable populations that have a high prevalence of active hepatitis C virus (HCV) infection.
Novel testing modalities and approaches is essential to hurdle the gap of unidentified patients with
active infection and to surveillance HCV reinfections.
DESCRIPTION OF MODEL OF CARE/INTERVENTION:
Active screening for HCV among vulnerable individuals is carried out in in settings where they
congregate through diagnosis in a single step (HCV Xpert) since March 2019.
A van adapted for the project and a car sets out to actively search and HCV/HIV/HBV screening to
identify those with active infection and is performed by a nurse and two educators hired specifically
for this purpose.
Screening is carried out with a rapid test. All positive results are confirmed within minutes using an
on-site PCR (Xpert® HCV Viral Load Fingerstick). For this test, 100μl of fingerstick capillary blood will
be collected by minivette. and results will be returned within 58 minutes.
In the case of a positive HCV or HIV PCR test, the participant is offered the possibility of referral to
hospital on the same day. HCV-infected patients who accept will be taken by car to the Hospital. The
patient is able to take medication from the hospital pharmacy on the same day.
EFFECTIVENESS: This van started its activity in March 2019 and in a moth of activity it has screening
301 vulnerable individuals (40.5% drug users and 60% homeless and migrants). Of these 13.9% have
a positive HCV antibody test and 36.5% of them have an active HCV infection (four reinfections
included). All positive HCV PCR results were delivered and 86% of them were linked to Hospitals.
CONCLUSIONS: Our preliminary results provide evidence suggest that rapid point-of-care tests and a
low-threshold population-based approach for the HCV allows for testing and linkage to care for
difficult-to-reach populations.
Disclosure of interest: This project received funds of Gilead and Abbie.