COVID-19 Pandemic as a Barrier For Hepatitis C (HCV) Elimination For People Who Use Drugs (PWUD) in Greece

Author: Pinelopi Antonakaki Harikleia Kranidioti Sofia Vasileiadi Nikolaos Papadopoulos Olga Anagnostou Melanie Deutsch Spilios Manolakopoulos

Theme: Models of Care Year: 2022

PWUD remain the key population in HCV elimination efforts. In Greece harm reduction
programs reduced and linkage to care with liver units became difficult due to regional
lockdowns. Our aim was to determine whether Covid-19 affected linkage to care and
treatment for PWUD and restrained HCV elimination programs.
We included 268 adult patients with HCV infection and a history of drug use, who visited our
outpatient liver clinic in order to start treatment from August 2018 until October 2021.
Patients were divided in two equal period groups: Group A (pts from Aug. 2018-Feb. 2020)
and Group B (March 2020-October 2021), based on the beginning of the pandemic in Greece
on March 2020.
203 patients consisted Group A and 65 patients Group B. All patients had HCV RNA(+) and
were eligible for antiviral treatment. Transient Elastography was performed in 141/268
patients. Almost half of the patients attended substitution programs in each of the two
groups. In Group A application for treatment in the national HCV registry was performed for
all 203 patients. 181/203 patients (80% male, mean age 46,5 ±10 years, 55% Gn3) initiated
treatment. In Group B, 65 patients were registered for HCV treatment and 49 (69,3% male,
mean age 48±9,5 years, 67% Gn3) started treatment (p=0,01). In Group A 146 patients
completed treatment and 108/146 had HCV-RNA testing for SVR vs 44 patients (Group B)
who completed treatment but only 15/44 patients (34%) were tested for HCV-RNA testing
(p<0,001). SVR rates were comparable between Group A vs Group B: 108/108 patients –
100%- vs 9/10-90%- patients.
There was a significant reduction in treatment initiation during the Covid-19 period. We also
observed that pandemic affects HCV treatment at several steps of the care cascade.
Implementation of new strategies are necessary in order to remain on HCV elimination track
particularly for vulnerable populations.
Disclosure of Interest Statement:

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