Theme: Models of Care Year: 2025
Background:
National data from 2021 indicates that 14% of persons tested for HCV had MDR-TB/HCV coinfection. WHO enlisted Ukraine in 12 MDR/RR-TB high-burdened countries. Since 2015, APH provided a comprehensive package of HCV services to almost 13,000 PLWH. In 2021, APH started treatment of HCV infection for TB/HCV co-infected people, who use drugs.
Description of the model of care/intervention:
HCV care was integrated into the APH project “Microelimination of HCV among key populations”. 10 field NGOs in 10 regions of Ukraine provided liaison with field HCFs, counselling clients, referrals for diagnosis, treatment, follow-up 12 weeks after the end of treatment, psychological support. To prepare NGOs to support TB people, APH conducted training for social workers on programmatic/clinical issues of TB/HCV co-infection management. The important integral of NGO activities was educational work with TB people on the HCV knowledge transfer and prevention of re-infection. 95% of TB patients were treated for HCV infection by doctors-infections in the departments of oblast TB centres. For 2021-2024, 287 HCV/TB co-infected patients were granted access to a comprehensive package of HCV services.
Effectiveness:
Of 287 people with TB/HCV co-infection, 94% (n=267) were PWID; other their partners. 91,5% (n=242) were male with an average age of 44 years. 56 PWID patients had HIV/HCV/TB infections, 98,2% (n=55) of them received ART. 18,4% (n=48) were OST patients. 94% of patients (n=248) completed full treatment course, 5 terminated treatment. 91% (n=147/162) of patients, who showed up for SVR12, reached it.
Conclusion and next steps:
Despite multiple infections, 91% of PWID with TB were cured. APH community-based HCV integrated treatment model, implemented by community-level NGOs, has demonstrated significant effectiveness and sustainability for TB patients who use drugs during the war.
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