Treatment Of Hepatitis C In A Community Based Opioid Substitution (OST) Clinic

Author: Bourke M, Cotter B, Hawthorne G, O’Driscoll D and Sweeny N

Theme: Models of Care Year: 2018

In 2017 an initiative to treat Hepatitis C in people who inject drugs (PWID) commenced in an
inner city addiction clinic (n=234) dispensing OST onsite, catering for a deprived indigenous
population, also serving Homeless Hostels (10). Delivery of the service was lead by a
general practitioner in partnership with a Hepatitis C specialist nurse, pharmacist and GP
Description of model of care/intervention:
A previous audit showed 67% to be Hepatitis C antibody positive, 80% of whom were PCR
positive. Excluded were co infected with HIV (accounting for 20%), previously treated, organ
transplant and decompensated liver disease. 45 were identified and offered a fibro scan on
site. Six patients with a fibro scan of >12.5KPa referred to hepatology. 39 patients had a
fibro scan <12.5KPa were suitable for treatment at the clinic. A Complete medical and pharmacy review was under taken with their community GP and pharmacy. All patients had a full DDI evaluation. A support group was set up with a local NGO, The Hepatitis C Partnership. This was facilitated by a project worker. Effectiveness: 30 patients completed treatment with appropriate DAA. All with a nil viral load. Treatment provided for Genotype 3 was Sofosbuvir™ / Velpatasvir™, genotype 1 was Viekirax™, Exviera™ /Ribavirin. Continued drug use was not a bar to treatment. Conclusion and next steps: Effective treatment can be provided in a primary care OST Service All patients treated to date have completed treatment with a nil viral load Ongoing drug use did not affect treatment Regular group meetings with the NGO improved programme delivery and individualised care proved extremely effective. Miro-elimation has commenced within the geographical area. Disclosure of Interest Statement: See example below: None of the collaborators have received funding for this. No pharmaceutical grants were received in the development of this. Note: If accepted into the programme you will be requested to include a disclosure of interest slide into your presentation or include such statements in your poster.

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