Assessment Of Hepatitis C At The Malmö Needle Exchange Program, Sweden

Author: Alanko Blomé M, Sommarström S, Isendahl P, Quick S , Alsterberg S, Munnecke Rigestam A, Jerkeman A

Theme: Clinical Research Year: 2017

Routine testing at the Malmö Needle Exchange Program (MNEP) has been based on detection of anti-HCV antibodies, but in 2016 testing for HCV viremia was made available to all participants. Examination by transient elastography with a mobile Fibroscan was also introduced on-site. The study objectives were to assess the prevalence and duration of chronic HCV infection among MNEP participants and to evaluate the self-perceived health status correlated to liver damage for a subset of viremic patients.
Results of HCV RNA PCR from anti-HCV positive visitors during 2016 were analyzed in correlation to age, gender and known duration of HCV infection. Data for self-perceived health status collected through 36-Item Short Form Survey and Fibroscan results were included for a subset (n=25) of the study cohort.
HCV RNA PCR data was available for 391 anti-HCV positive NEP visitors. For 35 of them, < 6 months had elapsed since the first anti-HCV positive test and chronicity could not yet be determined. For another 7 individuals, reinfection with recurrence of viremia after previously cleared infection was observed. Of the remaining 349 participants, 258 (74%) had chronic infection. Approximately half, 13 of 25 (52%) patients with a median duration of HCV infection of 20.5 years, F0-1, while 4 (16%) had F2, 2 (8%) F3 and 6 (24%) F4. Self-perceived general health status (Q1 of SF-36) was considered excellent, very good or good by 8 (32%) individuals and fair by 11 (44%) and poor by 6 (24%). The SF-36 results did not correlate statistically to the Fibroscan results. Conclusion A NEP may enable HCV diagnostics, assessment of liver damage and identification of patients in need of HCV treatment. Almost half of the examined subset (n=25) had treatment indication according to the current Swedish guidelines (>F2) and the majority (68%) perceived their health as fair-poor.

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