“Fibroscan Days” as a Tool to Patient Engagement in the Cascade of Care for Hepatitis C (HCV)

Author: Macphail G, Watson L, Edwards R

Theme: Clinical Research Year: 2015

An estimated 0.8% of the Canadian population has chronic HCV. CUPS, an inner-city community health centre, delivers care to people at risk of infection due to past or present drug injection drug use through an on-site multi-disciplinary HCV clinic. HCV serology is routinely offered to all patients presenting to CUPS for any type of care. Approximately 13% are HCV positive. It was postulated that bringing a fibroscan machine to the CUPS site and advertising to the shelters and partner agencies would increase awareness of liver health and HCV, resulting in identifying new infections and increasing access to care.

Methods: In collaboration with Gilead, a “Fibroscan Day” was planned. Word of mouth and posters were used to attract clients who were not usually part of the HCV program. Education, fibroscan, serology, and vaccinations were offered, along with refreshments.

Results: On the first Fibroscan Day in 2014, 67 people were seen. Thirty-one (46%) were known to have HCV. Ten (32% of HCV positives) had not previously accessed care through the CUPS HCV clinic. One new HIV diagnosis was made.
A second Fibroscan Day occurred 10 months later, with 60 participants. Forty-one (68%) had HCV, with one new diagnosis made. Twelve (29%) were no longer viremic. Of the 11 identified as treatment eligible, 7 are currently pursing therapy. Two others are HIV /HCV coinfected and followed elsewhere. The third Fibroscan Day was aimed at people currently in the process of evaluation for treatment. Twenty-five of the 27 people (93%) were HCV positive.

Conclusion: Bringing the fibroscan machine to our inner city health centre resulted in improved access to diagnosis and bridging to care. We are planning to make this a regular feature of our HCV program as an outreach and to engage people in the cascade of care.

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