Hepcare Europe: Hepcheck; Point Of Care Hepatitis C Testing In Vulnerable Populations

Author: John Lambert, Walter Cullen, Cristiana Oprea, Alistair Story, Juan Macias Sanchez, Julian Surey

Theme: Clinical Research Year: 2018

Background: HepCare Europe is a three-year EU funded project involving collaboration with four member states. It aims to create an innovative, integrated system for HCV testing & treatment among key ‘at-risk’ groups, including people who inject drugs (PWID) and the homeless, through outreach to the community and integration of primary and secondary care services. With clinical sites in Dublin, London, Seville and Bucharest, and economic evaluation in Bristol UK, the consortium is focused on operationalizing the multiple components of testing, care and cure that are key components of the strategy to eradicate HCV in the EU. Approach: The HepCheck component of the project offered screening across the four clinical sites in Dublin, London, Seville and Bucharest. Point of care testing was offered to ‘at- risk’ groups who are frequently marginalized with respect to health service engagement. Screening was conducted in prisons, opioid substitution treatment clinics and in homeless services. Outcome: A total of 2821 individuals were offered testing of which 2154 were screened, 34.2 % (n=728) tested HCV antibody positive. Of those 86% were male and 14% female, 47% reported previous &/or current homelessness, 60% were incarcerated or have a history of incarceration, 43% report a history of injecting drug use (IDU). In-depth analysis of cohort characteristics is ongoing and includes identification of HCV acquisition, risk factors, HCV related liver disease, other blood borne viruses and linkage to care. Conclusion: Community based screening across four EU sites highlighted similar (comparable) riskfactors. This cohort are being identified as they transition in and out of services yet are not being captured, further evaluated and cured of their HCV. Our data reinforces the need to improve linkage to care by developing engagement interventions within these community settings. Disclosure of Interest Statement: HepCare Europe is funded through the European Union with partial funding received from the Health Services Executive. Dr John S Lambert has also received unrestricted grants from the Pharmaceutical Industry to support his research work.

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