Theme: Models of Care Year: 2021
Background: Contact tracing has been a key element of the public health response to various infectious diseases yet has rarely been instituted in HCV because of difficulty identifying transmission events. With expanded screening programs to identify de novo HCV infection and HCV re-infection early, harnessing contact tracing processes may aid in identifying ongoing transmission clusters while also providing an opportunity to engage hard-to-reach individuals in HCV care to achieve network level micro-elimination. Methods: Our ongoing pilot program consists of early recognition of HCV infection (either first infection or reinfection) from a cohort of high-risk people who inject drugs. After diagnosing an early HCV infection, these ‘incident infections’ are asked, and incentivized, to have their contacts or ‘proximal partners’ (injection and sexual) screened for hepatitis C. All HCV infected members of the network are subsequently encouraged to receive HCV therapy concurrently with the goal of treating the transmitting partner at the same time as the newly infected participant to avoid the potential for cyclical transmission. Results: Five acute ‘incident infections’ were detected between September 2020 and March 2021, 2 first infections and 3 reinfections. Six ‘proximal partners’ were identified, 4 linked and screened for HCV, 1 was not reachable due to incarceration, and 1 had died. Of the 4 linked ‘proximal partners’, 3 were HCV PCR positive. All 8 (5 ‘incident infections’ and 3 ‘proximal partners’) were linked to an HCV provider and agreed to initiate HCV therapy, with 3 potential ‘incident infection’- ‘proximal partner’ pairs choosing to be treated together. Conclusion: Contact tracing programs for HCV could augment existing screening strategies to provide curative treatment for patients and their partners, prevent reciprocal transmission of HCV between risk partners and within networks, and potentially reach individuals who aren’t yet engaged in healthcare and harm reduction.
Download abstract Watch video