Author: Alsterberg S, Jerkeman A, Bråbäck M, Alanko Blomé M

Theme: Models of Care Year: 2019

Background: Malmö NEP opened in 1987 and has since reached > 5000 persons who inject drugs
(PWID), with 600 annual visitors. Successful transfer to OST clinics has left the majority using other
substances, mainly amphetamine. Despite a low prevalence and incidence of HIV and hepatitis B, the
prevalence and incidence of hepatitis C have remained high.
Description of model of care/intervention: Project ACTIONNE is a prospective open label study to
evaluate treatment of chronic Hepatitis C infection in PWID attending a Needle Exchange Program.
Fifty patients will receive treatment with glecaprevir/pibrentasvir for 8 weeks (F0-3) or 12 weeks
(F4). The primary endpoint is SVR at 12 weeks. Secondary endpoints are re-infections,
completion/adherence rates, virological kinetics and resistance patterns, effects on quality of life
and risk behaviour. Drug use is monitored during treatment. All steps within the cascade of care take
place at the NEP, including assessment by infectious disease and addiction care specialists.
Effectiveness: Inclusion will be from April 2018 to May 2019. So far, 47/50 patients have been
screened and 41 included. To date, 31 individuals have reached end of treatment, all without
detectable viremia and 21 have reached SVR 12. Only one drop-out has occurred so far. The median
age is 49 years, 78 % male, 90% F0-F3 and 10% F4, with 50 % gt 1a, 47 % 3a and 3 % gt 2b. Other
benefits such as increased nutrition, sleep, self esteem, and decreased drug intake during and after
treatment have been observed.
Conclusion and next steps: A well functioning NEP, equipped with medical resources for HCV
treatment can be used for offering the full cascade of care. This concept will have an impact on
individual and group levels concerning HCV related morbidity and mortality and should be
implemented in the NEP routines after the study period.
Disclosure of interest The Actionne study is an investigator initiated study, receiving funding from
Abbvie. Abbvie does not, however, have any access to data, nor impact on its interpretation,
publication or this submission.

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