Hepcare europe: Hepcheck; reaching vulnerable populations

Abstract

Background and Aims: HepCare Europe is a three year EU funded project involving collaboration with four member states. The vision for the project is to create an innovative, integrated system for HCV testing & treatment among key “at-risk” groups, including PWID's 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 has developed a number of work packages focused on operationalizing the multiple components of testing, care and cure that are key components of the strategy to eradicate HCV in the European Union. Consortium members include UCD (Ireland) SAS (Spain) SVB (Romania) University of Bristol (UK) and University College London (UK). Method: 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. Results: A total of 1,749 individuals were screened, 31.2% (n = 559) tested HCV antibody positive. To date 40% (n = 222) individuals have attended a specialist appointment for HCV treatment. In-depth analysis of the data is ongoing including identification of risk factors for HCV infection, levels of HCV related liver disease, prevalence of blood borne viruses and linkage to care. Conclusion: In order to achieve WHO HCV elimination targets by 2030 we need to identify and successfully treat the most vulnerable HCV individuals in the community. Community based screening intervention can enhance HCV diagnosis for at risk populations but referrals to/ attendance at secondary care remains a challenge for this cohort. The HepCheck data highlights the potential for developing interventions to enhance engagement with HCV screening and entry to the cascade of care required to cure HCV.