Screening For HCV With Dried Blood Spot Test In Active Drug Users. Evaluation Of Magnitude Before Intervention

Author: Ryan P, Valencia J, Troya J, Cuevas G, Resino S, Ramon C, Gutierrez J, Cabezon C, Vazquez-Moron S

Theme: Models of Care Year: 2018

Cañada Real is a shantytown on the outskirts of Madrid, where 90% of the sale and
consumption of illegal drugs in the region take place. Screening for HCV using dried blood
spot (DBS) in drug users is simple, cheap, avoids the need for venipuncture and can be
applied with only minimal training.
Screening for HCV and other viruses (HIV, HBV, HDV) was carried out using capillary whole
blood in DBS specimens in subjects from Cañada Real, as part of a low-threshold harm
reduction strategy. A mobile harm reduction unit made an active search. Socio-demographic
data was recorded.
529 drug users were screened for blood borne viruses at the shantytown. 78% were male,
79% Spanish born and 10% from Eastern Europe. 105 (20%) were homeless. Most frequent
drugs used; cocaine 476(90%), heroine 412 (78%). Most of the drug users smoked these
drugs 432 (87%) and 177(36%) injected them. 254 (50%) had previously injected drugs.
447(88%) were routinely followed at a health care facility (primary care, opioid substitution
center or mental health center or hospital). 28% (142) received opioid substitution therapy
and 29% psychiatric therapy. 15% did not have the right to medical assistance. 35% of the
drug users had not been tested/screening for hepatitis C in the last year. Screening results
with DBS: HCV antibodies: 28% positive, RNA positive: 23%, HIV positive: 6%, HBV
positive: 4% and 2 patients were HDV positive.
DBS may be an excellent alternative for blood borne viruses screening in drug users.
Proactive screening with DBS and active approaches to drug users help to quantify the
problem in this population, thus establish more suitable preventive measures and a circuit of
referral to specialist centers for confirmation of diagnosis and treatment.
Disclosure of Interest Statement:
The authors declare no conflict of interest in this work. This study was supported by grants
from Merck Sharpe & Dohme (MISP IIS#54846).

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