A novel hepatitis C intervention in Denmark to test and treat people who inject drugs

Thursday, 24 November, 2022 - 13:20 to 14:50
Knowledge market 3 (K3)

Abstract

Background: Providing testing and treatment for the hepatitis C virus (HCV) for people who inject drugs (PWID) is critical in eliminating it, but reaching this population with traditional healthcare services can be challenging. Combining point-of-care (PoC) testing with peer support and counselling is a model of care (MoC) that can be effective for PWID. This study aims to investigate if a peer-led mobile van equipped with rapid PoC tests for HCV antibodies (Ab) and RNA could simplify testing and link PWID to care and treatment.

Methods: In Copenhagen, Denmark, a peer-led mobile service providing counselling, Ab testing (In-Tecâ„¢) and linkage to standard care was equipped with a PoC HCV-RNA finger-prick test (Xpert HCV Viral Load Fingerstick PoC assay, Cepheid). Eligible HCV-RNA+ individuals were offered assisted referral to a fast-track hospital clinic for evaluation and treatment, with peer support available if needed.

Results: From 1 May 2019 to 25 October 2021, 1013 people were tested for HCV-RNA and 10.2% (n=103) were positive. Nine additional individuals with HCV infection contacted the service to be linked to care. Of the 112 individuals with chronic HCV infection, 72.3% (n=81) were evaluated for treatment at the hospital clinic, of whom 86.4% (n=70) initiated direct-acting antiviral therapy and 3.7% (n=3) are waiting to initiate treatment. Major reasons for not being evaluated for treatment included being undocumented (38.7%; n=12) and being lost to follow-up (32.3%; n=10). Among those who initiated treatment, 20.0% (n=14) were connected to drug addiction treatment services. The peer-led service assisted all treated with communication with the hospital nurse, collection of treatment medicine and accompaniment to follow-up visits.

Conclusion: We found that a peer-led mobile PoC service is an MoC that can engage PWID in HCV testing and link them to treatment, even during the COVID-19 pandemic. We identified being an undocumented migrant as a major cause for not accessing care. This poses a challenge for HCV elimination in Denmark due to the risk of onward transmission. Next steps include engaging with health authorities to provide care for these migrants.

Speakers

Presentation files

24 A8 1320 Jonas Demant.pdf641.28 KBDownload

Type

Tracks

Part of session