How To Set-Up A Hcv Treatment Program Within A Busy Methadone Program In Sydney, Australia.

Author: Smoker A, Hall E, Malcolm A, Montebello M, McKendrick L, Cowan T, Faros J, Finsterer K, Han E, Kearley J

Theme: Clinical Research Year: 2017

From March 2016, the Australian Government listed the new hepatitis C treatment medications on the Pharmaceutical Benefits Scheme (PBS), helping to facilitate accessible and affordable treatment for people living with the hepatitis C virus (HCV).
The Langton Centre (TLC) is a busy opioid substitution treatment (OST) service in the inner-city area of Sydney. The client population is characterised by chronic substance misuse, mental health issues, lower socioeconomic status, public housing residency, homelessness, Aboriginality, ongoing criminal justice involvement, and other chronic health and social issues.
TLC has successfully implemented a low threshold HCV treatment program that encourages treatment uptake and completion by many clients receiving OST.
Key strategies have included: staff training and development in HCV treatment, fibro scanning and venepuncture; development of database to monitor and maintain client progress; establishment of a weekly Liver Clinic; development of unique HCV treatment information for staff and clients; and development of external relationships with key stakeholders.
From July 2016 – April 2017:
• 125 clients have been screened for HCV treatment
• 27 clients previously thought to be HCV positive were confirmed as HCV negative
• 60 clients have commenced treatment
• 23 clients have achieved SVR12, which is 100% so far
• 5 clients have received hepatitis B vaccinations
• 23% OST clients at TLC are Aboriginal. Of those:
– 20% have attended the Liver Clinic
– 14% have commenced HCV treatment
– 14% have achieved SVR12
Even with the highly transient nature of our OST clients and evident complex barriers to treatment, providing a low threshold HCV treatment program that meets the needs of marginalised, hard to reach clients is not only achievable but beneficial in the overall reduction of the pool of virus in Australia, assisting in the achievement of the Australian Federal Government’s goal to eradicate HCV from Australia by 2026.

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