Theme: Models of Care Year: 2019
Background: As part of an elimination program for hepatitis C (HCV) in the Region of Southern
Denmark (RSD), a model of care was developed to assure large scale testing and treatment of people
who use drugs (PWUD) attending drug treatment centers (DTC). In Denmark HCV treatment has
mainly been hospital based with low treatment coverage of PWUD. Aim of the elimination program
is to attain the WHO goal of 90% diagnosed and 80% treated of PWUD attending DTC within 2022.
Description of model of care/intervention: At a population level it is a “Test and Treat strategy”
based on an existing model used at two DTC in RSD. The model provides the full cascade of care;
test, blood work for treatment evaluation, assessment of liver fibrosis by Fibroscan®, consultation by
infectious disease physician and HCV treatment at the DTC. When extended to the remaining 13 DTC
in RSD; it will provide care for an estimated 3000 PWUD. The expected chronic HCV prevalence
among opiate substitution recipients is 35%. By sequentially implementing the model over a 13
month period with an intensive test (two months) and subsequent treatment period (one month) at
each center, risk of re-infection is likely reduced. A repeat test intervention will take place 12 month
after the treatment to evaluate post intervention prevalence and incidence.
Effectiveness: The program commenced in March 2019 in the first center serving 168 clients of
which 90 receive opioid substitution therapy. Among 35 diagnosed with HCV 23 initiated treatment
during the treatment intervention. By September 2019 results from six centers will be available.
Conclusion and next steps: Preliminary results suggest that a large fraction of PWUD attending a
DTC can be engaged in treatment. It remains to be proven if this sequential model can eliminate HCV
both on diagnosis, prevalence and incidence targets.
Disclosure of Interest Statement: This study is supported by Gilead Sciences (CHIME grant). SD has
received research grants and travel support from Gilead. PBC has received research grants from
Gilead, Abbvie and MSD.
AØ has received research grants from Gilead and speaker fees and travel support from Gilead,
Abbvie and MSD