Theme: Models of Care Year: 2022
Background:
Providing testing and treatment for the hepatitis C virus (HCV) for people who inject drugs (PWID) is
critical in eliminating HCV but reaching this population with traditional healthcare services can be
challenging. Combining point-of-care (PoC) testing with peer support and counselling can be an
effective model of care for PWID.
Description of model of care/intervention:
In Copenhagen, Denmark, a peer-led mobile service providing counselling, Ab testing (In-Tech™) and
linkage to standard of care was equipped with a PoC HCV-RNA finger-prick test (Xpert HCV Viral Load
Fingerstick PoC assay, Cepheid). Eligible HCV-RNA+ PWID were offered assisted referral to a fasttrack hospital clinic for evaluation and treatment, with peer support available if needed.
Effectiveness:
During 1/5/2019-25/10/2021, 1,013 people were tested for HCV-RNA and 10.1% (n=102) were
positive. Nine additional HCV positive individuals contacted the service to be linked to care. Of the
111 individuals with chronic HCV infection, 73.0% (n=81) were evaluated for treatment at the
hospital clinic, of whom 86.4% (n=70) initiated treatment and 3.7% (n=3) are waiting to initiate it.
Major reasons for not being evaluated for treatment included being undocumented (36.7%; n=11)
and being lost to follow-up (33.3%; n=10). Among those who initiated treatment, 20.0% (n=14) were
connected to drug addiction treatment services. The peer-led service assisted all treated with
communication with the hospital nurse, collection of treatment medicine and accompaniment to
follow-up visits.
Conclusion and next steps:
A peer-led mobile PoC service is a model of care that can engage PWID in HCV testing and link them
to treatment, even during the COVID-19 pandemic. We identified being an undocumented migrant
as a major cause for not accessing care. This poses a challenge for HCV elimination in Denmark due
to the risk of onward transmission. Next steps include engaging with health authorities to provide
care for these migrants.
Disclosure of interest statement:
The mobile clinic is supported by the Danish Helsefonden (Health-Fund) and Sundhedsstyrelsen
(Danish Health Authority). This study was supported by AbbVie (grant number SA-02643), Gilead
Science (grant number 220001768) and MSD (financial educational grant signed 5/7/2019). JVL
acknowledges 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, outside
the submitted work. AØ reports grants, personal fees and other from AbbVie, Gilead Sciences and
MSD, outside the submitted work. JD reports grants from AbbVie, Gilead Sciences and MSD, outside
the submitted work. NW reports unrestricted grants and personal fees from AbbVie and Gilead
Sciences, and grants and personal fees from GSK and MSD, outside the submitted work. LK-D and JV
have nothing to disclose.