Theme: Epidemiology & Public Health Research Year: 2017
Background
HCV prevalence is very high among drug users in Greece. National Organization for Healthcare Services Provision (EOPYY) uses liver fibrosis stage as a major criterion for DAAs treatment reimbursement. Elastography, an excellent, non-invasive tool for measuring liver stiffness is not easily accessed by drug users: the cost is not covered by EOPYY while many hepatology clinics are not equipped by the relevant apparatus.
Aim of the study
To present the results of a collaboration activity between a patients organization and a public sector organization offering substitution treatment on overcoming CHC treatment barriers for drug users.
Methods
HELPA“Prometheus” visited OKANA substitution units in Greece (5/2016-3/2017) in the framework of the nationwide project entitled “I Deserve to Know”. Elastography was performed by HELPA“Prometheus” trained staff using FibroScan® 402, by Echosents. Results interpretation and patients’ counseling was done by OKANA medical doctor.
Results
HELPA“Prometheus” staff has visited OKANA units in 4 Greek regions (Attica, Volos, Thessaloniki and Veroia). In total 487 were tested by elastography (82% men, mean age of 45.4years).
The main indication for testing was HCV infection (N=461, 94.7%). HIV/HCV coinfection was reported by 21/461(4.6%) while HBV/HCV by 5/461(1%). Among HCV infected, 308 (66,8%), 38 (8.2%), 35 (7.6%) and 80 (17,4%) were F0-F1, F2, F3 and F4, respectively. All patients received medical counseling related to secondary prevention (life style changes, follow up recommendations) while those classified at stage F4 underwent further investigation and referred to a public hepatologist clinic in order to complete the procedure of treatment approval by EOPYY.
Conclusions
Through the collaboration, a barrier to CHC treatment access was overcome for a large number of drug users. Awareness of disease stage and counseling opportunities were increased while identification of patients needing treatment apart from helping patients on an individual level essentially contributes to country’s efforts for HCV elimination.