Theme: Models of Care Year: 2025
| Background: With Hepatitis C (HCV) elimination imminent, innovative strategies are essential to identify, support, and treat those still living with HCV. Efforts cannot waiver, with 75% of individuals unaware of their infection and liver-related deaths increasing fourfold over the past 50 years. This intervention leverages existing infrastructure to facilitate widespread testing, using a proactive and inclusive approach to identify individuals living with HCV and promptly link them to care.
Description of intervention: NHS England-funded blood-borne virus (BBV) screening was introduced to 34 Emergency Departments (EDs) across England in April 2022. HCV testing was incorporated at the Royal Sussex County Hospital in March 2023. During attendance, patients with routine liver function tests were offered HIV/HCV testing via implied consent. Regular training for ED staff, including ‘BBV Champions’ and ED huddle participation, encouraged uptake. Daily reports were sent to Hepatology nurses for triage. RNA testing was arranged for HCV antibody-positive cases. Individuals testing RNA positive were promptly linked to care with peer-worker support as needed. Effectiveness: Between March 2023 and September 2024, the project identified 40 new HCV diagnoses, 8 lost to follow-up (LTFU), 6 reinfections, and 15 already under hepatology. Of these, 16 had achieved sustained virological response (SVR), 11 were awaiting SVR, 3 were on treatment, 1 failed treatment, 7 were being prepared for treatment, 5 self-cleared and 4 were referred locally. The remaining disengaged, declined treatment, or were unreachable. 1 deceased. Conclusion and next steps: 56.5% of those testing HCV RNA positive engaged with the service. We identified hard-to-reach patients, re-engaged those LTFU, and captured SVR results as part of this process. Peer-support has been essential in engaging community patients. ED opt-out screening presents opportunities to access individuals who may not otherwise seek testing. The intervention has been a success, met minimal resistance, and proved effective in supporting HCV elimination. Disclosure of conflicts of interest:None. |