Hepatitis C services at harm reduction centres in the European Union: a 28-country survey

Juan M Pericàs,Kelly Safreed-Harmon,Piotr Wysocki,Daniel J Bromberg,Eberhard Schatz,Iwona Wawer,Denise Ocampo,Jeffrey V Lazarus

doi:10.1186/s12954-019-0290-x

Abstract

BackgroundIn the context of the WHO’s 2016 Viral Hepatitis Strategy and the introduction of treatment that can cure more than 95% of cases with hepatitis C virus (HCV) infection, the European Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT) undertook a study in the member states of the European Union (EU). It aimed to determine service providers’ understanding of the current services in their respective countries and the barriers experienced by PWID in accessing HCV testing, care and treatment services in their country.MethodsIn 2017, 38 purposively selected harm reduction service providers completed a 26-item English-language online survey addressing the availability, accessibility and funding of HCV services at harm reduction centres. HCV-related data and reported findings were extracted by country or by responding organization.ResultsResponses were received from all EU member states. Respondents from 23 countries reported that HCV tests are offered by harm reduction services in their countries, and eight countries reported that addiction specialists in their countries are able to prescribe HCV therapy. Almost half of the respondents (45%) said that their respective organizations had established referral systems with centres providing HCV treatment.ConclusionsNot all EU member states have harm reduction services that provide HCV tests, and many do not have established referral systems with treatment providers. Moreover, the inability of addiction specialists to prescribe HCV treatment points to missed opportunities to make treatment more accessible. Further, discrepancies were noted between the available HCV services and stakeholders’ knowledge about their availability.

Highlights

An estimated 15.6 million people injected illicit drugs worldwide in 2017 [1]
On-site testing services at harm reduction centres, pre-test counselling and education, dried blood spot testing, facilitated referral for hepatitis C virus (HCV) assessment and scheduling of specialist appointments have proved useful in enhancing access to various stages of the cascade, including for vulnerable populations such as the homeless, the uninsured, people who inject drugs (PWID) and other populations that may otherwise have no access to formal medical facilities [10, 11]
Thirty-eight harm reduction service providers from the 28 European Union (EU) member states responded to the survey

Summary

Introduction

An estimated 15.6 million people injected illicit drugs worldwide in 2017 [1]. In the absence of appropriate harm reduction measures, people who inject drugs (PWID) are disproportionately impacted by infectious diseases, viral infections among them. In the context of the WHO’s 2016 Viral Hepatitis Strategy and the introduction of treatment that can cure more than 95% of cases with hepatitis C virus (HCV) infection, the European Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT) undertook a study in the member states of the European Union (EU). It aimed to determine service providers’ understanding of the current services in their respective countries and the barriers experienced by PWID in accessing HCV testing, care and treatment services in their country

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Conclusion