Theme: Models of Care Year: 2022
Background:
COVID-19 impacted HCV elimination programs worldwide. Suspension of HCV services and limited access
has rendered engagement of the most marginalized patients particularly challenging.
Description of model of care/intervention:
HepCURE™ is a Canadian non-profit established in 2019. Our multidisciplinary team consists of clinicians,
nurses, phlebotomists, pharmacists and frontline workers. To maximize participation engagement, we
offer “community-based” point-of-care testing and phlebotomy service, program incentives (meal
vouchers, cell phones), SMS/phone appointment/adherence reminders, transportation, treatment
delivery services and 24/7 telephone support. To address the challenges posed by the pandemic, we
developed several initiatives:
– Three community-based clinics, and two mobile outreach units to screen participants in
marginalized settings across 20 cities in Ontario
– Use of geo-mapping to identify 500+ social support programs accessed by marginalized people
and 30+ pharmacies as partners to further support screening efforts and medication adherence
– HepCURE™ Patient Registry, an e-platform using informed verbal and/or photo consent to identify
at-risk patients, ensure linkage to treatment and monitor their clinical progress in real-time.
Effectiveness:
Over 12 months (2/2021-2/2022), we screened 3243 participants; 67% were male. (46%, mobile units;
29%, community-based clinics; 22%, pharmacies). The number of HCV Ab+, diagnosed, undiagnosed,
viremic, and linked to care patients are shown below.
• 40% (1312/3243) HCV Ab+
• 91% (1191/1312) Diagnosed (results shared with participants)
• 9% (121/1312) Undiagnosed (only completed point-of-care testing)
• 56% (738/1312) Confirmed viremia – HCV RNA+
• 80% (590/738) Linked to care (with HepCURE™, 540/590 – 92%)
• 20% (148/738) Not engaged with treatment
• 90% (485/540) Treated by HepCURE™
• 85% (411/485) Treatment completion.
Conclusion and next steps:
Our program was effective in diagnosing 91% of HCV Ab+ participants and linking 80% of treatment eligible patients to care. We’ve implemented new workflow processes and programmatic changes to
further improve patient retention. We’re currently replicating our program in another province to
demonstrate feasibility of a countrywide elimination model.
Disclosure of Interest Statement:
“HepCURE™ received grant funding from AbbVie Canada which was used in the development of its HCV
Model of Care.”