Earth Study (Phase 1): Expanding Access to Rapid Treatment for Hep C

Author: Menezes D, Surey J, Conneely J, Story A

Theme: Clinical Research Year: 2016


Menezes D 1, Surey J1, 2, Conneely J 3, Story A 1

1 Find&Treat, University College Hospitals, NHS Trust, London, 2 Institute of Global Health, University College London, 3 Hepatitis C Trust, UK

Background: Homeless populations include a large proportion of individuals at high risk of hepatitis C (HCV) infection and associated liver disease compounded by lifestyle factors such as alcohol. The EARTH Study is a programme of work to develop services for community based screening, liver assessment and supported treatment for homeless people. Phase 1 aims to assess the feasibility and effectiveness of peer facilitated active case finding for HCV among homeless people accessing an NHS mobile health unit.

Methods: A peer outreach worker with personal experience of HCV treatment interviewed people with HCV risk factors who were accessing homeless services across London. Testing was outreached using the Hepatitis C Trust or the Find&Treat mobile health unit. The peer provided point of care testing for HCV antibodies (HCV-Ab) using the OraQuick® HCV Rapid Antibody oral fluid test. All patients testing positive were referred to specialist Hepatology services.

Results: A total of 845 people were approached for testing, 444 declined with 72 (16%) doing so as they already knew their positive status.

Of the 401 individuals tested, 74 were HCV-Ab positive. Of these, 40 (54%) already knew their status (at least HCV-Ab positive) and 34 (46%) were new diagnoses. The average age among those positive was 42 years and over a third were currently injecting. 47% of all those reporting an injecting drug use history tested HCV-Ab positive

Conclusion: This confirms that there is a high prevalence of HCV among homeless people opportunistically screened across London. A high proportion knew of their status but had disengaged from treatment services.

Similarly, a considerable proportion were currently injecting and therefore at high risk of contributing to transmission amongst the homeless. This pilot data confirms that outreaching and testing in non-traditional settings can reach individuals with undiagnosed HCV who are at high risk of transmitting infection.

Disclosure of Interest Statement: The conference collaborators recognise the considerable contribution that industry partners make to professional and research activities. We also recognise the need for transparency of disclosure of potential conflicts of interest by acknowledging these relationships in publications and presentations. The authors declare that they have no conflict of interest.

Download abstract Download poster