HIV HCV HBV Screening and Fibroscan Sessions in Paris DCR

Author: Avril E, Debaulieu C, Dusouchet T, Volant J

Theme: Clinical Research Year: 2017

Background: Prevalence of viral hepatitis C is high among PWUD in France, 44% and access to treatment is low in this population, less than 5% are treated each year despite the new therapies. Paris drug consumption room (DCR) opened since October 2017 received precarious PWUD with complex and multiple addictions. Integrated in a DCR, FibroScan®, Rapid tests are opportunities for counseling and linkage to care.
Methods: Data monitoring of PWUD clients coming to the DCR, 6 months of survey. Medical consultation and awareness activities on hepatitis are proposed plus Fibroscan, HIV and HCV screening with rapid tests and HCV RNA with dried blood spot (DBS) for PWUD with extreme damaged veins.
Results: Since October 2017, 673 PWUD have been registered in the DCR, 45% declared HCV positive antibody, 5.4% HIV positive antibody. Intensive activity: 7 days per week, 7 hours a day, 31 383 visits (200 visits per day on average basis), 21 899 of which are injections. 105 rapid tests were achieved: 55 HIV test, 3 of which were positive, 50 HCV tests, 15 of which were positive, 15 dried blood spot were achieved, 8 of which positive for HCV RNA. 13 Fibroscan were performed,
Conclusion: FibroScan®, rapid tests and DBS are real good Harm Reduction tools which are easily performed in a DCR and allow access to very precarious population and improve their linkage to care. But improving access to SVR needs to develop a cooperative model of care integrating social support (housing, health care coverage), a by pass consultation in a reference hospital for hepatitis C, and treatment delivery. This presentation is part of the Correlation HCV/harm reduction workshop.

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