Successful Interventions for HCV in The Inner City in COVID World

Author: Brian Conway Rossitta Yung Shawn Sharm Leo Yamamoto David Truong

Theme: Models of Care Year: 2022

When comparing Hepatitis C Virus (HCV) treatment starts in the province of British Columbia between the first 6 months of 2019 and 2020, a 38% decrease was measured, largely attributed to the changes in health care delivery models in the era of the COVID-19 pandemic. This has affected the inner city in a disproportionate manner.
There is an urgent need to develop structures to address this situation and get back on track for HCV elimination by the end of the decade.
We measured HCV treatment starts within the context of an intervention designed to provide antiviral therapy within a multidisciplinary program to address medical, psychological, social and addiction-related needs in a low threshold and flexible setting. In the COVID pandemic era, there were short periods (March-May/2020 and again in August 2020) where interactions with the community were limited due to public health measures. Outside of these periods, we were able to implement programs that were based in residences in the inner city with single room occupancy units where we could interact with HCV-infected individuals in a manner consistent with public health regulations, with personal distancing, mask wearing and hand sanitation in a controlled manner while restoring access to antiviral therapy in a consistent manner. This replaced previous programs based in community centres that were closed. We have evaluated HCV treatment starts/month from 01/19 – 11/21 to determine the impact our strategies within the context of the COVID-19 pandemic.
As shown in Figure 1, between 01-06, we had 62 HCV treatment starts in 2019, and 43 in 2020, a 31% year-to-year decrease. This was largely due to a significant reduction in April, May and August 2020, at the height of public health restrictions on the provision of direct health care. In the second half of 2020, there was an increase to 55 treatment starts. In 2021, there has now been an average of 67 starts/6 months.

With insightful programs consistent with current public health regulations in COVIDworld, it is possible to provide HCV treatment in the inner city at a rate that equals or exceeds that achieved in the pre-pandemic era, restoring the interventions required to achieve HCV elimination by 2030.
Disclosure of Interest:
B. Conway Grant / Research support for: AbbVie, Gilead, Indivior, Merck, Sanofi Pasteur and ViiV Healthcare, L.
Yamamoto: None Declared, S. Sharma: None Declared, R. Yung: None Declared, D. Truong: None Declared.

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