Theme: Models of Care Year: 2019
Background: World Health Organisation estimates approximately 37 million people are living with HIV
(PLWH) globally; with 2.9 million co-infected with Hepatitis C (HCV). It urges that priority be placed on
diagnosis, treatment and linkage to care for co-infected individuals. NHS Tayside specialist liver service
audited treatment of co-infection to date.
Description of model of care: Testing PLWH for HCV is routine practice. NHS Tayside operates an
integrated care pathway – with full responsibility for HIV testing and prescribing for known PLWH in the
area – wherein co-infected individuals are managed by infectious diseases physicians, with input from
hepatologists, specialist nurses and pharmacists via weekly multi-disciplinary meetings. Co-infected
individuals are treated for HCV by physician closest to them. Data from all known patients with HCV/HIV
co-infection in Tayside is collected on a clinical database which was retrospectively analysed.
Effectiveness: 394 PLWH were identified as ever having received care in Tayside; 48/394 were coinfected and eligible for HCV treatment. 46 underwent HCV therapy with 2 awaiting treatment. HCV
regimen for 30 was PEGylated interferon +/- ribavirin, and direct acting antivirals for 16. Forty achieved
sustained viral response (SVR), 5 died pre-SVR test, one result is awaited. The main risk factor for HCV in
this cohort is injecting drugs (N=39). Currently 360 PLWH receive HIV care in Tayside, 350 (97%) have
been HCV tested and are aware of their status, 3% are likely to have been tested anonymously, but may
be yet untested.
Conclusion: Most PLWH in Tayside currently know their HCV status and linkage to care is effective for
co-infected individuals due to multidisciplinary care structure, distributive leadership and co-location of
blood-borne virus screening. Most co-infected individuals were treated successfully, but some died postHCV treatment, and further engagement is required of those awaiting therapy. Analyses are underway
to determine if micro-elimination has been achieved.
Disclosure of Interest: JFD has honoraria for lectures and research grants from Janssen-Cilag, Roche,
Merck Sharp & Dohme, AbbVie, Bristol-Myers Squibb, & Gilead.
CB declares no conflict of interest.
ER declares no conflict of interest.
NR declares no conflict of interes