A novel hepatitis C intervention in Denmark to test and treat people who inject drugs

Lazarus, Jeffrey V.; Øvrehus, Anne; Demant, Jonas; Krohn-Hehli, Louise; Weis, Nina

doi:10.1016/s0168-8278(20)31114-4

Cited by 3 publications

(4 citation statements)

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“…This finding is not surprising and consistent with the broader HCV literature among PWID where rates of loss to follow‐up or DAA treatment discontinuation have been reported in 5%–10% 11,16,47 . Treatment uptake was also higher than reported from mobile HCV clinics in Brisbane, Copenhagen and Madrid 32,35,37 . Despite being similar mobile units, these studies were conducted in urban settings and did not integrate peer support with POC testing and treatment initiation without additional specialist consultation.…”

Section: Discussionsupporting

confidence: 83%

“…11,16,47 Treatment uptake was also higher than reported from mobile HCV clinics in Brisbane, Copenhagen and Madrid. 32,35,37 Despite being similar mobile units, these studies were conducted in urban settings and did not integrate peer support with POC testing and treatment initiation without additional specialist consultation.…”

Section: Hepatitis C Virus Rna Prevalencementioning

confidence: 99%

“…Promising outcomes have been reported following POC testing in community‐based services, including needle and syringe programs, pop‐up clinics, mobile harm reduction units and community pharmacies 31–37 . Although there are examples of successful mobile HCV clinics, 32,35,37 they have been conducted in typical urban settings, and few have combined POC testing with peer support. To our knowledge, this is the first study reporting on the effectiveness of a peer‐driven mobile HCV clinic providing services in small towns, integrating POC HCV RNA testing, liver disease staging and treatment initiation in a one‐step process facilitated by peer support.…”

Section: Introductionmentioning

confidence: 99%

“…[27][28][29][30] Promising outcomes have been reported following POC testing in community-based services, including needle and syringe programs, pop-up clinics, mobile harm reduction units and community pharmacies. [31][32][33][34][35][36][37] Although there are examples of successful mobile HCV clinics, 32,35,37 they have been conducted in typical urban settings, and few have combined POC testing with peer support.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Peer support in small towns: A decentralized mobile Hepatitis C virus clinic for people who inject drugs

Midgard

Bjørnestad²,

Egeland³

et al. 2022

Liver International

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Background & Aims: New models of HCV care are needed to reach people who inject drugs (PWID). The primary aim was to evaluate HCV treatment uptake among HCV RNA positive individuals identified by point-of-care (POC) testing and liver disease assessment in a peer-driven decentralized mobile clinic.Methods: This prospective study included consecutive patients assessed in a mobile clinic visiting 32 small towns in Southern Norway from November 2019 to November 2020. The clinic was staffed by a bus driver and a social educator offering POC HCV RNA testing (GeneXpert®), liver disease staging (FibroScan® 402) and peer support.Viremic individuals were offered prompt pan-genotypic treatment prescribed by local hospital-employed specialists following a brief telephone assessment.Results: Among 296 tested individuals, 102 (34%) were HCV RNA positive (median age 51 years, 77% male, 24% advanced liver fibrosis/cirrhosis). All participants had a history of injecting drug use, 71% reported past 3 months injecting, and 37% received opioid agonist treatment. Treatment uptake within 6 months following enrolment was achieved in 88%. Treatment uptake was negatively associated with recent injecting (aHR 0.60; 95% CI 0.36-0.98), harmful alcohol consumption (aHR 0.44; 95% CI 0.20-0.99), and advanced liver fibrosis/cirrhosis (aHR 0.44; 95% CI 0.25-0.80). HCV RNA prevalence increased with age (OR 1.81 per 10-year increase; 95% 1.41-2.32), ranging from 3% among those <30 years to 55% among those ≥60 years. Conclusions:A peer-driven mobile HCV clinic is an effective and feasible model of care that should be considered for broader implementation to reach PWID outside the urban centres.

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Section: Discussionsupporting

confidence: 83%