Access to Hepatitis C Care for Underserved PWID: Provision Rapid Testing and Fibrosis Assessment in Drug Consumption Rooms

Author: Philip Bruggmann, Peter Menzi, Regine Hofmann, Nathalie Brunner

Theme: Clinical Research Year: 2015

Lack of priority on both, patients and addiction care provider side is a main reason for the hepatitis C(HCV) care gap among people who inject drugs (PWID). Provision of transient elastography has been shown to be effective to engage PWID for hepatitis C care. Consumption rooms run by social workers and nurses are well frequented by active PWID. With combining these two approaches PWID unaware of their HCV status should be reached.
Hepatitis C counselling and saliva rapid testing along with transient elastography was provided anonymously and for free over a period of 6 half-days to the attendants of the consumption rooms in the city of Zurich. Positive tested patients were offered capillary blood sampling for HCV RNA testing and genotyping. Patients with chronic hepatitis C were referred for further assessment and treatment to an addiction unit with integrated hepatitis care.
85 patients agreed to participate; median age was 43, 70% were male, 65% under substitution treatment. 67 (79%) accepted to be tested for HCV, 76 (89%) for transient elastography. 50 of the 85 patients reported a history of iv drug use, 27 (40%) HCV antibody rapid tests were positive. From 16 HCV RNA determinations 9 were positive (13% of all HCV antibody tested). Fibroscan results over 7.1kPa (moderate fibrosis or more) were found in 16 patients (21%), over 9.5kPa (severe fibrosis) in 6 patients (8%).
Offering hepatitis C testing along with transient elastography in consumption rooms is a promising way to engage PWID for HCV and liver health care.

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