Theme: Models of Care Year: 2021
Background: In the Balearic Islands, Spain, there are an estimated 1,120 people who use drugs (PWUD) with undiagnosed hepatitis C virus (HCV) infection. We created a new model of care to simplify and evaluate the HCV care pathway for PWUD on the Balearic Islands. Due to the COVID-19 pandemic, to date the project has been initiated at one site. We present preliminary results. Description of model of care/intervention: This new model of care will be implemented across 17 sites, in four different settings: addiction service centres (n=12), non-governmental organizations (NGOs) (n=3), a mobile methadone unit, and a prison. The intervention protocol consists of four phases, adapted to each setting: recruitment and testing on site by point-of-care test (Oraquick®, OraSure Technologies Inc.); linkage to care; treatment prescription via telemedicine; and monitoring on site of sustained virological response 12 weeks post-treatment and reinfection. Effectiveness: Of the 73 recruited patients, 65 (89%) were tested for anti-HCV Ab and 7 (11%) were positive. 8/73 (11%) were not tested due to reporting a previous diagnosis. 3/65 (5%) had a negative antiHCV Ab result, even when reporting a previous diagnosis. Taking this into account, 18/73 (25%) need viremia confirmation. Amongst these 18 patients: the mean age was 45 years (SD: 7.76); 15 (83%) were men and 17 (94%) Spanish-born; 12 (67%) had previous HCV treatment; 1 (5%) reported active drug and alcohol use; and 9 (50%) believed they were infected by past injecting drug use, 1 (5%) by sexual practice, 2 (11%) did not know, and 7 (39%) did not respond. Conclusion and next steps: This new model of care can simplify the HCV care pathway for PWUD in the Balearic Islands, by testing in situ and prescribing treatment through telemedicine. The next steps in 2021 are to expand the interventions to the remaining 16 sites. Disclosure of interest statement: Funding for this project was provided by Gilead Sciences. JVL, AH, CAP, and MV-R acknowledge support to ISGlobal from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019-2023” Programme (CEX2018-000806-S) and from the Government of Catalonia through the CERCA Programme. JVL further acknowledges grants and speaker fees from Gilead Sciences and MSD, and speaker fees from Genfit and Intercept, all outside the submitted work. MB reports advisory fees from Gilead Sciences, Abbvie, GlaxoSmithKline, and Assembly Biosciences and speaker fees from Gilead Sciences and Abbvie, outside of the submitted work. AP, ET, and AV have nothing to declare.
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