PTU-033 Hepatitis c; pathways reaching the population other pathways can't reach. (June 2019)

• Record Type: Journal Article
• Authors: Robinson, Emma; Brennan, Paul; Manca, Francesco; Boyd, Kathleen; Dillon, John
• Is Part Of: Gut. Volume 68(2019)Supplement 2
• Page Start: A128
• Page End: A129
• Publication Date: 2019-06
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2019-BSGAbstracts.242
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: NHS Tayside is committed to eradicating the Hepatitis C virus (HCV) by 2030 in line with the World Health Organisation recommendations. This includes diagnosing at least 90% of those infected. With an estimated prevalence of 0.55% we anticipate that we should have 2700 people with chronic HCV. 2300 are diagnosed and have either been treated and cured or are in line to be treated. We anticipate that a further 400 are un-diagnosed. It is vital that we diagnose and treat these individuals in order to prevent further transmission of the virus and achieve elimination. NHS Tayside have instituted a number of specialised pathways for testing and treatment of HCV amongst the most at-risk populations, including people who inject drugs (PWID), those on opiate substitution therapy and prison inmates. Widespread testing occurs in injecting equipment provision sites (IEPS), community pharmacies, substance misuse centres and the prison service. Our aim was to analyse the efficacy of these directed diagnosis pathways compared with standard testing. Methods: Data was collected for every Hepatitis C IgG and PCR test ever done in NHS Tayside. We attributed each test to a diagnosis pathway according to the testing source. Clinical records show testing source for every individual in NHS Tayside with positive antibody results. Pooling this data allowed us to assess pathway efficacy. Results: Overall the diagnostic activity for HCV has increased over the last two decades. More markedly since 2012 when DAAs were becoming available. The standard diagnostic pathways (primary and secondary care) show large volume testing with a low rate of PCR positivity. In contrast testing pathways aimed at high risk individuals show a higher PCR positive rate. See figure 1. Conclusions: Utilisation of diagnostic pathways targeting populations most at risk of HCV are more effective at yielding new HCV diagnoses than standard pathways. These tailored diagnostic pathways will also resolve some of the health inequalities around drug use and provide methods of ensuring entry to treatment. We believe using targeted testing will find the majority of our undiagnosed population. This will help us to direct resources and achieve our aim of elimination by 2030.