Theme: Models of Care Year: 2022
Background:
There remains a high residual burden of untreated chronic HCV infection in priority populations across
Canada, particularly in people who inject drugs. More recently, the COVID-19 crisis has negatively
impacted the delivery of testing and treatment for HCV-infected patients. Opioid Substitution Treatment
(OST) clinics and Overdose Prevention Sites (OPS) present an opportunity to optimize HCV care by
leveraging resources and infrastructure to better engage these populations in HCV screening.
Description of model of care:
From 10/2021 – 02/2022, outreach workers offered HCV-Ab point-of-care testing (POCT) to at-risk
individuals attending an OST clinic and an OPS location in Toronto, Canada. POCT results were provided
to clients after 5 minutes using VIRCAN 5-Minute Rule 1. For all positive POCT individuals, dried blood
spot (DBS) samples were further collected for HCV-RNA testing. Liver disease assessment and HCV
treatment was provided virtually by a physician at time of testing and/or subsequent follow-up of DBS
results.
Effectiveness:
181 clients were screened, with 121 (67%) coming from OST setting.
89/181 (49%) were HCV-Ab positive, with 89/89 completing DBS.
84/89 (94%) were linked to a physician for virtual consultation.
30/89 had detectable virus.
20/30 received HCV treatment (4 awaiting treatment; 6 lost to follow-up or refused treatment).
All treated individuals were from OST setting, with an average time of less than 2 weeks from diagnosis
to treatment.
Conclusion(s) and next steps:
Combining HCV screening with access to virtual HCV care by a physician leads to efficient linkage to care
(94%, 84/89). Our preliminary data further suggests that linkage to treatment is greater in the OST
setting (95%, 20/21) compared to OPS (0%, 0/9). Strategies should focus on screening and access to
virtual care in OST settings during the pandemic to reach micro-elimination targets.
Disclosure of interest: None