Hepatitis C Testing, Care And Treatment At Harm Reduction Centres In The European Union: A 28-Country Survey Of Service Providers

Author: Lazarus JV, Bromberg DJ, Schatz E, Wawer I, Wysocki P, Safreed-Harmon K

Theme: Epidemiology & Public Health Research Year: 2017

Background: Major international organizations, including UNAIDS, UNODC and
WHO, recommend that viral hepatitis prevention, vaccination, diagnosis and
treatment be available to people who inject drugs (PWID) as part of a
comprehensive harm reduction package. In the context of the 2016 WHO global
viral hepatitis elimination strategy, and the recent introduction of direct acting
antivirals that can cure more than 95% of chronic hepatitis C virus (HCV) cases,
the European Joint Action on HIV and Co-infection Prevention and Harm
Reduction undertook a study to collect data on HCV testing, care and treatment
from harm reduction service providers in the European Union (EU).
Methods: In 2017, we invited 38 purposively-selected providers of harm reduction
services for PWID in the 28 EU member states to complete a 26-item online survey
addressing the availability, accessibility and funding of harm reduction services.
Data were captured using the RedCap online survey platform. We extracted key
HCV-related data and reported findings by country (n=29, as England and
Scotland are reported separately) or responding organisation.
Results: The response rate was 100%. Respondents from 22 countries reported
that hepatitis C tests are offered by harm-reduction services in their countries.
Respondents from 7 countries reported that addiction specialists in their countries
are able to prescribe HCV therapy. Almost half of the respondents (45%) said that
their respective organizations had established referral systems with hospitals or
clinics that administer HCV treatment.
Conclusion: Eliminating hepatitis C requires a concerted effort targeting people
who inject drugs. This study indicates that not all EU countries have harm
reduction services that provide HCV tests, and that many harm reduction services
have not established referral systems with HCV treatment providers. Further, the
reported lack of prescribing of HCV treatment by addiction specialists in many
countries points to missed opportunities to make treatment more accessible.
Disclosure of Interest Statement: This research was conducted as part of the
joint action ‘677085 / HA-REACT,’ which has received funding from the European
Union’s Health Programme (2014-2020). Additional financial support was provided
by the Correlation Network, the Netherlands.

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