Pursuing Micro-Elimination Of HCV Among PWID In An OST Clinic In Southern Switzerland: The Implementation Of DAA Therapy Through An Interdisciplinary Approach

Author: Borojevic M, Finessi V, Rudel G, Pignieri A, Moriggia A

Theme: Models of Care Year: 2018

Background: Hepatitis C among people who inject drugs (PWID) is highly prevalent in Southern Switzerland, as they are considered the “reservoir” of HCV infection. PWID have historically limited access to medical care if delivered in a conventional system of patients’ referral to specialized centers. On the other hand, there is good evidence that medical treatment can be effective if delivered in an integrated interdisciplinary model involving addiction, psychiatric, psychosocial and somatic care. Approach: We described the evolution of HCV treatment delivery in an addiction center in Southern Switzerland, with a population of about 120 PWID on opioid substitution therapy (OST) every year, since the introduction in 2014 of DAA therapy as an integrated interdisciplinary care model, involving HCV specialist, trained nurses, psychosocial and psychiatric care as well as harm reduction service, point of care HCV testing and linkage to care. The interdisciplinary model included also educational events for the whole staff and screening events for patients. Outcome: Three patients were treated in 2014, while 14 and 20 patients received treatment in 2015 and 2016. Eight patients were treated in 2017. Of 45 patients treated, 4 got reinfected with HCV, 2 died during treatment and 3 died after the end of treatment. During 2015-2017 several educational events for the staff and for patients were delivered and three sessions of point of care free liver stiffness assessment were performed. Conclusion: Access to HCV treatment evolved together with the education of the multidisciplinary staff and the involvement of patients in project of HCV screening and linkage to care. Microelimination of HCV from all the patients attending our clinic seems to be feasible in a relatively short time, with the empowerment of all different actors: physicians, nurses, psychosocial staff and patients. Disclosure of Interest Statement: See example below: Ingrado and Epatocentro Foundation are partially funded by MSD, Gilead, Abbvie. No direct funding was assigned to the authors for writing this abstract.

Download abstract Download Poster