Theme: Epidemiology & Public Health Research Year: 2019
Background:
Since highly effective treatment to cure HCV infection is available now, we have to focus on our
ability to deliver care and to accompany HCV-infected patient up to cure. cmuQL is a specialized
HIV/HCV clinic with a holistic program of care, substitution program (SPO), community pharmacist,
nursing and social worker follow up for persons with substance abuse. The aim of this study was to
describe our HCV cascade of care and investigate the potential gape in our model of care.
Methods:
All patients with positive HCV antibody attending health services in cmuQL between 2010-2018 were
included. HCV positive patients with ≥2 medical visits were considered to be linked in care. Lab data,
medical follow-up, liver stiffness (biopsy/ultrasound/fibroscan), and treatment information were
provided from the electronic medical chart (EMC). For patients with HCV re-infection or multiple
treatments we considered only their last situation. Comparisons were done by 2 and determinant
of treatment initiation, going up to end of treatment and SVR were analyzed by logistical regression
using SPSS.
Results:
Between 2010 and 2018, 1135 antiHCV+ patients received care at cmuQL. Of these 1100 (97%) were
linked to care, 966 (85%) had an RNA test, 753 (66%) underwent liver fibrosis assessment, 77 (7%)
cleared the virus spontaneously, 825 received treatment (73%) and 799 achieved SVR (70%).
Neither HIV/HCV-coinfection (OR=0.76; 95%CI=0.57-1.02) nor SPO (OR=1.07; 95%CI=0.74-1.54) or
gender (OR=1.06; 95%CI=0.78-1.46) were barrier to access treatment or get cure at cmuQL.
Conclusion:
Analyses showed that in an HIV/HCV specialized clinic with substitution program and holistic care,
maintaining patients into care and reaching cure could be successful. The largest gap in the HCVcare-cascade was seen in initiating treatment. Greater emphasis on linking patients to clinical
evaluation and treatment is necessary in order to achieve the elimination of hepatitis C as a public
health threat.
Disclosure of Interest Statement:
Machouf N, Huchet E, Poliquin M, Baril JG, Hamel A & Trottier B have been speaker for various
pharmaceutical companies (Merck, Gilead, ViiV, BMS)