HEPCARE EUROPE: A Case study of a Service Innovation Project Aiming at Improving the Elimination of HCV in Vulnerable Populations in Four European Cities

Gordona Avramovic; Sandra Bivegete; Peter T Vickerman; Josephine G Walker; Zoe D Ward; John S Lambert; et al.

doi:10.1016/j.ijid.2020.09.1445

HEPCARE EUROPE: A Case study of a Service Innovation Project Aiming at Improving the Elimination of HCV in Vulnerable Populations in Four European Cities

Gordona Avramovic, Sandra Bivegete, Peter T Vickerman, Josephine G Walker, Zoe D Ward, John S Lambert^*, et al.

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

Objectives
Hepatitis C Virus (HCV) is an important cause of chronic liver disease. Among at-risk populations, access to diagnosis and treatment is challenging. We describe an integrated model of care, Hepcare Europe, developed to address this challenge.

Methods
Using a case-study approach, we describe the cascade of care outcomes at all sites. Costing analyses estimated the cost per person screened and linked to care.

Results
A total of 2608 participants were recruited across 218 clinical sites. HCV antibody test results were obtained for 2568(98.5%), 1074(41.8%) were antibody-positive, 687(60.5%) tested positive for HCV-RNA, 650(60.5%) were linked to care and 319(43.5%) started treatment. 196(61.4%) of treatment initiates achieved a Sustained Viral Response (SVR) at dataset closure, 108(33.9%) were still on treatment, 8(2.7%) defaulted from treatment, and 7(2.6%) had a virologic failure or died. The cost per person screened varied from Є194 to Є635, while cost per person linked to care varied from Є364 to Є2035.

Conclusions
Hepcare enhanced access to HCV treatment and cure, costs were affordable in all settings, offering a framework for scale-up and reproducibility.

Original language	English
Pages (from-to)	374-379
Number of pages	6
Journal	International Journal of Infectious Diseases
Volume	101
Early online date	28 Sept 2020
DOIs	https://doi.org/10.1016/j.ijid.2020.09.1445
Publication status	Published - 1 Dec 2020

Keywords

Hepatitis C
Vulnerable populations
people who inject drugs (PWID)
integrated HCV care
cascade of caresystem of care
HCV elimination

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{c06fef27f9464ee1b73f0481bc08f242,

title = "HEPCARE EUROPE: A Case study of a Service Innovation Project Aiming at Improving the Elimination of HCV in Vulnerable Populations in Four European Cities",

abstract = "ObjectivesHepatitis C Virus (HCV) is an important cause of chronic liver disease. Among at-risk populations, access to diagnosis and treatment is challenging. We describe an integrated model of care, Hepcare Europe, developed to address this challenge.MethodsUsing a case-study approach, we describe the cascade of care outcomes at all sites. Costing analyses estimated the cost per person screened and linked to care.ResultsA total of 2608 participants were recruited across 218 clinical sites. HCV antibody test results were obtained for 2568(98.5%), 1074(41.8%) were antibody-positive, 687(60.5%) tested positive for HCV-RNA, 650(60.5%) were linked to care and 319(43.5%) started treatment. 196(61.4%) of treatment initiates achieved a Sustained Viral Response (SVR) at dataset closure, 108(33.9%) were still on treatment, 8(2.7%) defaulted from treatment, and 7(2.6%) had a virologic failure or died. The cost per person screened varied from Є194 to Є635, while cost per person linked to care varied from Є364 to Є2035.ConclusionsHepcare enhanced access to HCV treatment and cure, costs were affordable in all settings, offering a framework for scale-up and reproducibility.",

keywords = "Hepatitis C, Vulnerable populations, people who inject drugs (PWID), integrated HCV care, cascade of caresystem of care, HCV elimination",

author = "Gordona Avramovic and Sandra Bivegete and Vickerman, {Peter T} and Walker, {Josephine G} and Ward, {Zoe D} and Lambert, {John S} and et al.",

year = "2020",

month = dec,

day = "1",

doi = "10.1016/j.ijid.2020.09.1445",

language = "English",

volume = "101",

pages = "374--379",

journal = "International Journal of Infectious Diseases",

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publisher = "Elsevier",

}

HEPCARE EUROPE: A Case study of a Service Innovation Project Aiming at Improving the Elimination of HCV in Vulnerable Populations in Four European Cities. / Avramovic, Gordona; Bivegete, Sandra ; Vickerman, Peter T et al.
In: International Journal of Infectious Diseases, Vol. 101, 01.12.2020, p. 374-379.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - HEPCARE EUROPE

T2 - A Case study of a Service Innovation Project Aiming at Improving the Elimination of HCV in Vulnerable Populations in Four European Cities

AU - Avramovic, Gordona

AU - Bivegete, Sandra

AU - Vickerman, Peter T

AU - Walker, Josephine G

AU - Ward, Zoe D

AU - Lambert, John S

AU - al., et

PY - 2020/12/1

Y1 - 2020/12/1

N2 - ObjectivesHepatitis C Virus (HCV) is an important cause of chronic liver disease. Among at-risk populations, access to diagnosis and treatment is challenging. We describe an integrated model of care, Hepcare Europe, developed to address this challenge.MethodsUsing a case-study approach, we describe the cascade of care outcomes at all sites. Costing analyses estimated the cost per person screened and linked to care.ResultsA total of 2608 participants were recruited across 218 clinical sites. HCV antibody test results were obtained for 2568(98.5%), 1074(41.8%) were antibody-positive, 687(60.5%) tested positive for HCV-RNA, 650(60.5%) were linked to care and 319(43.5%) started treatment. 196(61.4%) of treatment initiates achieved a Sustained Viral Response (SVR) at dataset closure, 108(33.9%) were still on treatment, 8(2.7%) defaulted from treatment, and 7(2.6%) had a virologic failure or died. The cost per person screened varied from Є194 to Є635, while cost per person linked to care varied from Є364 to Є2035.ConclusionsHepcare enhanced access to HCV treatment and cure, costs were affordable in all settings, offering a framework for scale-up and reproducibility.

AB - ObjectivesHepatitis C Virus (HCV) is an important cause of chronic liver disease. Among at-risk populations, access to diagnosis and treatment is challenging. We describe an integrated model of care, Hepcare Europe, developed to address this challenge.MethodsUsing a case-study approach, we describe the cascade of care outcomes at all sites. Costing analyses estimated the cost per person screened and linked to care.ResultsA total of 2608 participants were recruited across 218 clinical sites. HCV antibody test results were obtained for 2568(98.5%), 1074(41.8%) were antibody-positive, 687(60.5%) tested positive for HCV-RNA, 650(60.5%) were linked to care and 319(43.5%) started treatment. 196(61.4%) of treatment initiates achieved a Sustained Viral Response (SVR) at dataset closure, 108(33.9%) were still on treatment, 8(2.7%) defaulted from treatment, and 7(2.6%) had a virologic failure or died. The cost per person screened varied from Є194 to Є635, while cost per person linked to care varied from Є364 to Є2035.ConclusionsHepcare enhanced access to HCV treatment and cure, costs were affordable in all settings, offering a framework for scale-up and reproducibility.

KW - Hepatitis C

KW - Vulnerable populations

KW - people who inject drugs (PWID)

KW - integrated HCV care

KW - cascade of caresystem of care

KW - HCV elimination

U2 - 10.1016/j.ijid.2020.09.1445

DO - 10.1016/j.ijid.2020.09.1445

M3 - Article (Academic Journal)

C2 - 32992012

SN - 1201-9712

VL - 101

SP - 374

EP - 379

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

ER -

HEPCARE EUROPE: A Case study of a Service Innovation Project Aiming at Improving the Elimination of HCV in Vulnerable Populations in Four European Cities

Abstract

Keywords

UN SDGs

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