Integrating Hepatitis C Care For At-Risk Groups: Findings From A Multi-Centre Observational Study In Primary And Community Care

Author: Swan D, O’Connor E, McCombe G, Nic an Riogh E, Avramovic G1, Macias J, Oprea C, Story A, Surey J, Vickerman P, Lambert J, Ianache I, Cullen W

Theme: Epidemiology & Public Health Research Year: 2018

In the EU, primary care is increasingly providing long-term care for people who inject drugs
(PWID), and thus is a key setting to target to address HCV-related morbidity and mortality
among PWID. The HepLink study aims to improve HCV care outcomes among PWID in
primary and community care by developing an integrated model of HCV care and evaluating
its feasibility, acceptability and likely efficacy.
The integrated model of care comprises: education of community practitioners, clinical
support/outreach by a HCV-trained nurse to primary care and community sites, and
enhanced access of patients to community-based evaluation of HCV disease (including onsite Fibroscan). GP practices/clinical sites in Dublin (DUB), London (LDN), Bucharest (BUC)
and Seville (SEV) were recruited from the professional networks of consortium members.
Patients were eligible to participate if ≥ 18 years of age, on opioid substitution treatment or at
risk of HCV, and attending the practice/service during the recruitment period. Data on patient
demographics and current HCV management were collected on participating patients at
Twenty-nine practices/services (DUB n=14; LDN n=2; SEV n=4; BUC n=9) are currently
participating. A total of 486 patients have been recruited across the four sites (DUB n=135;
LDN n=35, SEV n=109; BUC n=207) and baseline data has been collected on 472 patients.
Across the four sites, participants ranged in age from 19-90 years with 71-90% male.
Baseline data showed that lifetime HCV testing ranged from 53% (BUC) to 96% (SEV). HCV
positivity ranged from 77% (DUB) to 100% (SEV). Among HCV-positive patients, lifetime
attendance at a hepatology/infectious disease service ranged from 7% (LDN) to 53% (DUB)
and HCV treatment from 3% (LDN) to 35% (SEV).
Current management of HCV across these four European sites shows substantial variability
in HCV screening, linkage to care and treatment rates among PWID.
Disclosure of Interest Statement:
No conflicts of interest.

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