Theme: Epidemiology & Public Health Research Year: 2017
From Testing to Viral Suppression: The HCV Care Continuum at an Urban Harm Reduction Agency and Syringe Exchange in Philadelphia, PA
Background: Hepatitis C virus (HCV) is the most common blood-borne infection in the United States, with an estimated prevalence of 5 million people. Approximately 75%-85% individuals who become infected with HCV will develop a chronic infection. Injection drug use is the most common mode of transmission. The Philadelphia Department of Public Health (PDPH) estimates that 47,525 individuals (a 2.9% incidence rate) in Philadelphia are infected with HCV and more than 60% were infected through injection drug use. PDPH reports that that 9% of individuals have received HCV treatment.
Objective: To describe the HCV care cascade at Prevention Point Philadelphia (PPP), an urban harm reduction agency.
Methods: A no-risk chart review was conducted for any individual who received an HCV test at Prevention Point Philadelphia.
Results: Since 2012, PPP has tested 3,088 individuals for HCV, finding that 1,808 (58.5%) individuals tested HCV AB+. Of those, 622 (34%) received a confirmatory HCV blood draw at PPP and 442 (71%) were confirmed positive for HCV. Of those that were confirmed positive, 364 (82%) were enrolled in case management services and 244 (55%) attended a medical appointment. Currently, 60 individuals (3.3%) have achieved a sustained virologic response (SVR).
Conclusion: Incidence of HCV is high while SVR rates are low in the IDU population accessing HCV testing at PPP. Focus should be shifted to increasing the retention of patients in order to move patients more efficiently through the care cascade.
Implication: Harm reduction service centers have the ability to access and assist vulnerable populations successfully through the HCV care cascade to achieve SVR.Download abstract