Optimising the Opportunity of HCV Testing and Treatment Within a Large Substance Misuse Service

Author: Carrie Richardson Deborah Moores John Fox Anne-Marie McMullan Catherine Wigglesworth Elle-Rose Davies

Theme: Models of Care Year: 2022

People who inject drugs (PWID) across the UK often face difficulties in accessing hepatitis C (HCV)
testing and treatment. Many individuals are engaged with substance misuse services (SMS) and
experience challenges when navigating pathways and overcoming barriers to accessing secondary
care resulting in missed opportunities for HCV treatment. Forward Leeds is one of the country’s
largest SMS providers; in 2020 of 3556 patients in treatment (of which 2151 are receiving Opiate
Substitution Treatment (OST) 311 were tested for HCV. It was identified that due to historical
methods of BBV testing there may be a resistance to HCV testing facilitated by non-clinical staff
leading to missed opportunities to identify positive cases for treatment.
Description of model of care/intervention:
Multidisciplinary approach to increased HCV case finding that included the Leeds Viral Hepatitis
Team, Forward Leeds and HCT. All parties contributed to planning where HCV treatment pathways
were reviewed and HCV testing was integrated within OST appointments. Initial test (HCV+) to
treatment referral time was reduced to 5 days. Awareness and testing campaigns jointly delivered by
all stakeholders. BBV testing delivery was widened from clinical to staff and peer led testing. A
robust training package implemented including e-learning and Hepatitis Awareness Training
provided by the HCT peers with lived experience. This included several sessions to ensure staff
confidence in HCV discussions and Dry Blood Spot testing.
HCV tests done: 1631 (311 previously, 524% increase)
HCV+: 139 (8.5% prevalence)
HCV treatment starts: 119 (85.6% of HCV+)
Total staff BBV trained: 73
Staff demonstrated increased BBV knowledge and continue to generate awareness and test when
Conclusion and next steps:
Multidisciplinary approach with emphasis on peer training delivers greater testing numbers.
Maintain emphasis on testing within remaining cohort of patients and ensure that work within the
OST cohort of patients is given focus. SVR12 data to follow to inform degree of treatment success.
Disclosure of Interest Statement:
The Hepatitis C Trust has received funding via the NHS England elimination agenda through Abbvie
to fund the Peer Programme in West Yorkshire.

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