Expanding Access to Hepatitis Care among People Who Inject Drugs (PWID): One Year of Fibroscans at the Kirketon Road Centre


Author: S Grummett Gilliver R, Scholey K, van Beek I, Read P

Theme: Clinical Research Year: 2015

Introduction:
The Kirketon Road Centre (KRC) is a publically funded primary health care facility involved in the prevention, treatment and care of HIV and viral hepatitis to people who inject drugs. In April 2014 KRC obtained a portable Fibroscan which has been used on site and in outreach settings such as the NSW Users and AIDS Association NSP and the Medically Supervised Injecting Centre. The aim of this study was to describe results and retention in care of the 1st year of clients receiving fibroscans.

Methods:
All clients who underwent a fibroscan from April 2014 through March 2015 were included. Clients’ demographics, fibroscan results, HCV genotype, HIV co-infection and follow-up data were analysed.

Key Findings:
Fibroscans were performed among 161 clients: 106 male, 51 female, 4 transgender. Median age was 43, and 12 (7%) identified as Aboriginal; 146 (91%) reported having injected drugs. 72% (n=116) were HCV PCR positive (58% genotype 1, 38% genotype 3; 7 were HIV co-infected); 17 were hepatitis B sAg positive (1 HIV co-infected). 28 were of unknown status. Fibroscans showed F0-1 liver fibrosis in 105 (65%), F2=28(17%), F3=16(10%) and F4=12(8%,). Follow-up occurred in 122 clients (76%), including 26/28 with F3-4 fibrosis. Thirteen clients were able to access Clinical Research trials of HCV treatment.

Discussion:
This study demonstrates that Fibroscans delivered to PWID in NSP and harm reduction settings leads to good uptake and retention in care. These outreach services have an important role in delivering the hepatitis C strategy to harder-to-reach members of this priority population.

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