Coordinated assistance plan for the elimination of hepatitis C virus at the centro de ayuda integral al drogodependiente (CAID (Comprehensive Care Centre for Drug Addicts))

Gastroenterol Hepatol. 2021 Mar;44(3):214-220. doi: 10.1016/j.gastrohep.2020.08.002. Epub 2020 Nov 6.
[Article in English, Spanish]

Abstract

Introduction: The drug-injecting population has a high prevalence of hepatitis C virus (HCV) and high risk of transmission. It is a priority to establish an agile diagnostic and treatment plan.

Objectives: 1) Assess the effectiveness of a new coordinated care plan of referral from the Comprehensive Care Centre for Drug Addicts (CAID) to specialised care and 2) Determine the prevalence of HCV, clinical characteristics, effectiveness and safety of treatment in this population.

Methods: 1,300 serologies requested by the CAID between 1998 and 2018 were retrospectively analysed, the seroprevalence of HCV was calculated and the efficiency of the traditional CAID-specialised care referral system was evaluated. A care plan was designed and coordinated among specialists involved in diagnosis and treatment. Since October 2018, 11 patients have been included in the new plan and the performance of both referral systems was compared.

Results: With the traditional system, 48.2% (83/172) of the patients were lost. 14.5% (172/1,300) presented positive HCV serology, compared to the general population OR = 19; 95% CI 14.3-25. The prevalence of active infection was 80.3% (90/112). The prevalence of active infection was 80.3% (90/112). Of the 11 patients referred by the new plan, 76.9% (8/11) had active infection and 100% (8/8) were treated with Direct Antiviral Agents successfully.

Conclusions: The new coordinated CAID-specialised care plan presents high effectiveness in comparison with the traditional referral system. The seroprevalence and prevalence of active infection in the CAID population is very high. Treatments with Direct Antiviral Agents are effective and safe.

Keywords: Centro Atención Integral al Drogodependiente; Comprehensive Care Centre for Drug Addicts; Hepatitis C virus; People who inject drugs; Personas que se inyectan drogas; Virus hepatitis C.

MeSH terms

  • Adult
  • Female
  • Hepatitis C / blood
  • Hepatitis C / diagnosis*
  • Hepatitis C / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Referral and Consultation / organization & administration*
  • Retrospective Studies
  • Substance Abuse Treatment Centers