Author: Collin PG, Aponte-Melendez Y, Davis L, Fong C, Eckhardt BJ, Kapadia SN, Marks KM, Smith M, Mateu-Gelabert P

Theme: Epidemiology & Public Health Research Year: 2019

Background: With the success of engaging PCID in HCV treatment, it is crucial to evaluate for non-HCV
medical conditions. PCID often have co-morbidities related to or independent of their substance-use,
which greatly impact their health. Characterizing non-HCV chronic diseases and healthcare utilization
will significantly impact opportunities for both HCV and overall healthcare engagement among PCID.
Methods: Baseline data from 114 participants in an ongoing study of HCV care for PCID delivered at a
syringe services program (SSP) in New York City are presented here. HCV RNA-positive participants were
eligible if they had injected drugs in the past 90 days and were not currently engaged in HCV treatment.
Participants were randomized to receive either on-site HCV treatment at the SSP or referred to local
HCV providers. Structured interviews gathered data about chronic disease prevalence and healthcare
Results: Among 114 participants, the mean age is 42.7 years; 78.1% male; 57.9% Hispanic; 30.7% nonHispanic white; 6.1% non-Hispanic black; 97.3% insured. 59.6% were homeless within the last 3 months.
34.8% reported a chronic disease other than HCV, the most common being HIV co-infection (9.6%),
hypertension (5.3%) and asthma (4.4%). Of patients with at least 1 non-HCV chronic disease, 82.1% had
seen a healthcare provider for a non-HCV reason within 90 days compared to 37.0% without a chronic
disease. At baseline, 29.8% had at least one healthcare visit within 90 days for preventive care, 14.0%
for acute complaints and 11.4% for mental health.
Conclusion: In PCID with HCV, there is a significant non-HCV chronic disease burden and high healthcare
utilization. In this cohort of PCID without linkage to HCV treatment, many reported recent engagement
with healthcare. This indicates missed opportunities for initiating HCV care and the potential need for
increased screening or improved tactics in introducing HCV care in primary care settings.
Disclosure of Interest Statement: Dr. Eckhardt has received research grants to New York University from
Gilead Sciences Inc. Dr.
Kapadia has received research grants to Weill Cornell from Gilead Sciences Inc. Dr. Marks has
received research grants to Weill Cornell from Gilead Sciences Inc, Merck, and Bristol-Meyers
Squibb. No pharmaceutical grants were received in the development of this study.

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