HepCare Ireland-a service innovation project.
HepCare
Hepatitis C (HCV)
Integrated care
Peer support
People who inject drugs (PWID)
Journal
Irish journal of medical science
ISSN: 1863-4362
Titre abrégé: Ir J Med Sci
Pays: Ireland
ID NLM: 7806864
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
11
05
2020
accepted:
23
07
2020
pubmed:
8
8
2020
medline:
1
5
2021
entrez:
8
8
2020
Statut:
ppublish
Résumé
Hepatitis C virus (HCV) remains a major cause of morbidity and death worldwide, with prevalence highest among people who inject drugs (PWID), homeless populations and prisoners. The World Health Organization has published targets to be achieved by 2030 as part of its global health sector strategy to eliminate viral hepatitis. Recent innovations in testing and treatment of HCV mean such goals are achievable with effective infrastructure, political will and funding. 'HepCare Europe' was a 3-year, EU-funded project involving four member states. It sought to develop, implement and evaluate interventions to improve HCV outcomes through multiple-level interventions, running between 2016 and 2019. This paper aims to summarize the methods and present the aggregate cascade of care figures for the Irish components of HepCare. 'HepCare Ireland' contained five integrated work packages: HepCheck, HepLink, HepFriend, HepEd and HepCost. Interventions included intensified screening, community-based assessment, linkage to specialist care, peer training and support, multidisciplinary educational resources and cost-effectiveness analysis. A total of 812 participants were recruited across the three clinical work packages in Ireland. Two hundred and fifty-seven (31.7%) of the tested participants had an HCV antibody-positive result, with 162 (63.0%) testing positive for HCV RNA. At the time of writing (6th of November 2019), 57 (54.8%) of participants put on treatment had achieved SVR12, with 44 (42.3%) still undergoing treatment. In HepCheck, HepLink. HepEd and HepFriend, we demonstrate a series of interventions to improve Irish HCV outcomes. Our findings highlight the benefits of multilevel interventions in HCV care.
Identifiants
pubmed: 32761548
doi: 10.1007/s11845-020-02324-1
pii: 10.1007/s11845-020-02324-1
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
587-595Subventions
Organisme : European Commission
ID : 709844
Références
Cooke G, Andrieux-Meyer I, Applegate T et al (2019) Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 4(2):135–184. https://doi.org/10.1016/S2468-1253(18)30270-X
doi: 10.1016/S2468-1253(18)30270-X
pubmed: 30647010
Chen S, Morgan T (2006) The natural history of hepatitis C virus (HCV) infection. Int J Med Sci 3(2):47–52. https://doi.org/10.7150/ijms.3.47
doi: 10.7150/ijms.3.47
pubmed: 16614742
pmcid: 1415841
Hutchinson S, Bird S, Goldberg D (2005) Modelling the current and future disease burden of hepatitis C among injection drug users in Scotland. Hepatology. 42(3):711–723. https://doi.org/10.1002/hep.20836
doi: 10.1002/hep.20836
pubmed: 16116637
Matser A, Urbanus A, Geskus R et al (2012) The effect of hepatitis C treatment and human immunodeficiency virus (HIV) co-infection on the disease burden of hepatitis C among injecting drug users in Amsterdam. Addiction. 107(3):614–623. https://doi.org/10.1371/journal.pone.0163488
doi: 10.1371/journal.pone.0163488
pubmed: 21919987
Thornton L, Murphy N, Jones L et al (2012) Determination of the burden of hepatitis C virus infection in Ireland. Epidemiol Infect 140(8):1461–1468. https://doi.org/10.1017/S0950268811001920
doi: 10.1017/S0950268811001920
pubmed: 21923968
European Centre for Disease Prevention and Control (2016) Systematic Review on Hepatitis B and C Prevalence in the EU/EEA. ECDC, Stockholm. https://doi.org/10.2900/24396
doi: 10.2900/24396
Razavi H, Robbins S, Zeuzem S et al (2017) Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a Modelling study. Lancet Gastroenterol Hepatol 2(5):325–336. https://doi.org/10.1016/S2468-1253(17)30045-6
doi: 10.1016/S2468-1253(17)30045-6
Crowley D, Murtagh R, Cullen W et al (2019) Hepatitis C virus infection in Irish drug users and prisoners – a scoping review. BMC Infect Dis 19(1):702. https://doi.org/10.1186/s12879-019-4218-6
doi: 10.1186/s12879-019-4218-6
pubmed: 31395032
pmcid: 6686252
Cullen W, Stanley J, Langton D et al (2007) Management of hepatitis C among drug users attending general practice in Ireland: baseline data from the Dublin area hepatitis C in general practice initiative. Eur J Gen Pract 13(1):5–12. https://doi.org/10.1080/14017430601049365
doi: 10.1080/14017430601049365
pubmed: 17366287
Lazarus J, Pericàs J, Picchio C et al (2019) We know DAAs work, so now what? Simplifying models of care to enhance the hepatitis C Cascade. J Intern Med 286(5):503–525
doi: 10.1111/joim.12972
The World Health Organisation (2016) Global health sector strategy on viral hepatitis 2016–2021 towards ending viral hepatitis. WHO Press, Geneva, p 22
Irving W, Smith S, Cater R et al (2006) Clinical pathways for patients with newly diagnosed hepatitis C - what actually happens. J Viral Hepat 13(4):264–271. https://doi.org/10.1111/j.1365-2893.2005.00698.x
doi: 10.1111/j.1365-2893.2005.00698.x
pubmed: 16611193
Fourati S, Feld J, Chevaliez S, Luhmann N Approaches for simplified HCV diagnostic algorithms. J Int AIDS Soc 21(S2):e25058. https://doi.org/10.1002/jia2.25058
Zhou K, Fitzpatrick T, Walsh N et al (2016) Interventions to optimise the care continuum for chronic viral hepatitis: a systematic review and meta-analyses. Lancet Infect Dis 16(12):1409–1422. https://doi.org/10.1016/S1473-3099(16)30208-0
doi: 10.1016/S1473-3099(16)30208-0
pubmed: 27615026
Swan D, Cullen W, Macias J et al (2018) Hepcare Europe - bridging the gap in the treatment of hepatitis C: study protocol. Expert Rev Gastroenterol Hepatol 12(3):303–314. https://doi.org/10.1080/17474124.2018.1424541
doi: 10.1080/17474124.2018.1424541
pubmed: 29300496
Lambert J, Murtagh R, Menezes D et al (2019) ‘HepCheck Dublin’: an intensified hepatitis C screening programme in a homeless population demonstrates the need for alternative models of care. BMC Infect Dis 19(1):128. https://doi.org/10.1186/s12879-019-3748-2
doi: 10.1186/s12879-019-3748-2
pubmed: 30732573
pmcid: 6367728
Bruggmann P, Grebely J (2015) Prevention, treatment and care of hepatitis C virus infection among people who inject drugs. Int J Drug Policy 26(S1):S22–S26. https://doi.org/10.1016/j.drugpo.2014.08.014
doi: 10.1016/j.drugpo.2014.08.014
pubmed: 25245939
McCombe G, Swan D, O’Connor E et al (2018) Integrated hepatitis C care for people who inject drugs (Heplink): protocol for a feasibility study in primary care. JMIR Res Protoc 7(6):e149. https://doi.org/10.2196/resprot.9043
doi: 10.2196/resprot.9043
pubmed: 29866641
pmcid: 6006011
Henderson C, Madden A, Kelsall J (2017) ‘Beyond the willing & the waiting’ — the role of peer-based approaches in hepatitis C diagnosis & treatment. Int J Drug Policy 50:111–115. https://doi.org/10.1016/j.drugpo.2017.08.004
doi: 10.1016/j.drugpo.2017.08.004
pubmed: 28927831
Treloar C, Rance J, Haber P et al (2014) How to build trustworthy hepatitis C services in an opioid treatment clinic? A qualitative study of clients and health workers in a co-located setting. Int J Drug Policy 25:865–870. https://doi.org/10.1016/j.drugpo.2014.01.011
doi: 10.1016/j.drugpo.2014.01.011
pubmed: 24559604
Grebely J, Knight E, Genoway K et al (2010) Optimizing assessment and treatment for hepatitis C virus infection in illicit drug users: a novel model incorporating multidisciplinary care and peer support. Eur J Gastroenterol Hepatol 22(3):270–277. https://doi.org/10.14288/1.0339810
doi: 10.14288/1.0339810
pubmed: 20425880
Shearer Lambert J, McHugh T, Perry N et al (2018) Development of HepFriend; a Dublin community hepatitis C peer support model. Int J Integr Care 18(S2):1–8. https://doi.org/10.5334/ijic.s2368
doi: 10.5334/ijic.s2368
McCombe G, Almaazmi B, Lambert JS et al Integrating primary and secondary care to optimise hepatitis C treatment: development and evaluation of a multidisciplinary educational ‘Masterclass’ series. Int J Integr Care 17(5):A359, 1–8. https://doi.org/10.5334/ijic.3677
Barror S, Avramovic G, Oprea C et al (2019) HepCare Europe: a service innovation project. HepCheck: enhancing HCV identification and linkage to care for vulnerable populations through intensified outreach screening. A prospective multisite feasibility study. J Antimicrob Chemother 74(S5):v39–v46. https://doi.org/10.1093/jac/dkz455
doi: 10.1093/jac/dkz455
pubmed: 31782499
pmcid: 6883392
Swan D, McCombe G, O'Connor E et al (2018) Integrating hepatitis C care for at-risk groups: findings from a multi-centre observational study in primary and community care. Int J Integr Care 18(s2):360. https://doi.org/10.5334/ijic.s2360
doi: 10.5334/ijic.s2360
Nic An Riogh E, Swan D, McCombe G et al (2019) Integrating hepatitis C care for at-risk groups (HepLink): baseline data from a multicentre feasibility study in primary and community care. J Antimicrob Chemother 74(5):v31–v38. https://doi.org/10.1093/jac/dkz454
doi: 10.1093/jac/dkz454
pubmed: 31782502
pmcid: 6883390
Surey J, Menezes D, Story A et al (2018) Community interventions and peer support for active case finding and treatment support for underserved populations with hepatitis C in the UK, Ireland, Romania and Spain as part of the HEPCARE Programme. J Hepatol 68:S181–S182. https://doi.org/10.1186/s12912-019-0347-x
doi: 10.1186/s12912-019-0347-x
Crowley D, Murtagh R, Cullen W et al (2019) Evaluating peer-supported screening as a hepatitis C case-finding model in prisoners. Harm Reduct J 16(1):42. https://doi.org/10.1186/s12954-019-0313-7
doi: 10.1186/s12954-019-0313-7
pubmed: 31277665
pmcid: 6612120
Avramovic G, Oprea C, Surey J et al (2020) HepCare Europe—a service innovation project. HepCheck: characteristics of the patient population with active infection as defined by HCV RNA. Int J Infect Dis 91:246–251. https://doi.org/10.1016/j.ijid.2019.11.027
doi: 10.1016/j.ijid.2019.11.027
pubmed: 31785401
Harrison G, Murray K, Gore R et al (2019) The hepatitis C awareness through to treatment (HepCATT) study: improving the Cascade of Care for Hepatitis C Virus-Infected People who inject drugs in England. Addiction. 114(6):1113–1122. https://doi.org/10.1111/add.14569
doi: 10.1111/add.14569
pubmed: 30694582
Hickman M, Dillon J, Elliott L et al (2019) Evaluating the population impact of hepatitis C direct acting antiviral treatment as prevention for people who inject drugs (EPIToPe) – a natural experiment (protocol). BMJ Open 9(9):e029538. https://doi.org/10.1136/bmjopen-2019-029538
doi: 10.1136/bmjopen-2019-029538
pubmed: 31551376
pmcid: 6773339
Arora S, Thornton K, Murata G et al (2011) Outcomes of treatment for hepatitis C virus infection by primary care providers. N Engl J Med 364(23):2199–2207. https://doi.org/10.1056/NEJMoa1009370
doi: 10.1056/NEJMoa1009370
pubmed: 21631316
Grebely J, Alavi M, Micallef M et al (2015) Treatment for hepatitis C virus infection among people who inject drugs attending opioid substitution treatment and community health clinics: the ETHOS study. Addiction. 111(2):311–319. https://doi.org/10.1111/add.13197