Identification, Assessment And Management Of Hepatitis C Virus (HCV) And Delivering Direct Acting Antiviral (DAA) Treatment In Outreach Setting.

Author: Sinan F, Agarwal K, Badot MA, Broughton S, Hodgson S, Oakes K

Theme: Models of Care Year: 2018

Background: Substance Misusers are the main reservoir for Hepatitis C Virus infection (HCV) but around 50% of cases remain undiagnosed (Public Health England, 2017). Hence, linkage to care has been recognised as a priority for this group, with the requirement for HCV services to reach out into the community to actively case find. King’s College Hospital Viral Hepatitis Service (KCHVHS), working in partnership with Change Grow Live (CGL), implemented changes to existing outreach clinics to increase client engagement and linkage to care. Approach: CGL is a voluntary sector organisation which provides support, treatment and rehabilitation programmes for substance misusers. CGL Southwark hosted an outreach clinic staffed by part time KCHVHS clinical nurse specialist (CNS) from June 2016 increasing to full-time CNS resource from November 2017. Clients were assessed for liver disease and treated for HCV with Directly Acting Antiviral (DAA) therapy. A parallel data search of 850 registered clients was also performed. Outcome: Total 72 clients started treatment in CGL Part-time nurse – 24% Full-time nurse – 76% A data search of 480/850 clients was performed between November 2017- April 2018. • 22% were HCV RNA positive • Genotyping and Fibroscan were performed for 60% of clients • All clients were approved for treatment at MDM • 86% of these clients have commenced, completed or due to start treatment Conclusion: Employment of a full time CNS, education about treatment and provision of flexible appointment times has helped to improve client engagement. Furthermore, utilizing pre-existing data has helped to identify clients who were lost to follow up resulting in the better management of HCV. 40% of clients have an unknown HCV status. We hope to screen these engaged clients with no recent HCV RNA result. By addressing undiagnosed HCV in this population we hope to work towards HCV elimination. References Public Health England. Hepatitis C in the UK. 2017. Available at: tis_C_in_the _UK_2016_report. pdf. [Accessed 08 March 2018].

Download abstract Download Poster