Eradicate Hepatitis C Virus A pilot of treatment as a prevention in active drug users Mike Burns CEO CAIR Scotland The Eradicate HCV Programme Integrated Health amp Social Care Team Dr John Dillon NHS Tayside ID: 276105
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Slide1
Making the Impossible Possible
Eradicate Hepatitis C Virus A pilot of treatment as a prevention in active drug users
Mike Burns, CEO
CAIR ScotlandSlide2
The Eradicate HCV Programme Integrated Health & Social Care Team
Dr John Dillon NHS Tayside
Brian Stephens NHS Tayside
Jan
Tait
NHS Tayside
Daniel Kelly CAIR Scotland
Ingrid Hainey CAIR Scotland
Mike Burns CAIR Scotland
Ann
Eriksen
NHS Tayside
Executive LeadsSlide3
Dry Blood Spot Testing
0.5%
Average UK Prevalence of HCV
1%
Tayside Prevalence of HCV
20%
Prevalence in Injecting Drug Users in Tayside
2285
Estimated Positive Population in Tayside
The partnership between CAIR Scotland and NHS Tayside, starting in 2009, contributed to an almost 200% increase in confirmed new HCV diagnosis in Tayside
Resulted in funding to carry out an Eradication Study with a view to eradicating Hepatitis C.Slide4
How our IEP and Needle Exchange services have impacted and improved the care pathway for injecting drug users who have HCV
Dry Blood Spot Testing
1,700
Individuals in drug treatment in Dundee
65%
Average DNA RateSlide5
Testing
930
DBST Carried out in the CAIR Scotland Needle Exchange Centre, City of Dundee
89%
Returned for Results
80%
From our most socially deprived areas
70%
Currently in Drug Treatment
Re-testingSlide6
Eradicate HVC Monthly Recruitment
119 applied to come on programme
51 on programmeSlide7
Genotype
GenderSlide8
Eligibility
119 discussed the study with programme staff.46 were not eligible73 were eligible51 consented to take part to dateSlide9
Reason for IneligibilitySlide10
Eligible Patient BreakdownSlide11
Consented Patient OutcomeSlide12
Participant Treatment Pathway
Genotype 1
Treated with
1)
PEGInterferon
Alpha
2) Weight based ribavirin and telaprevirFor 12 weeks with a further 12 weeks of combination therapy. If the patient is not responding to treatment at 4 or 8 weeks the therapy is stopped.Those patients who complete 24 weeks of therapy and were not GVC PCR undetectable at 4 weeks of therapy would be offered up to 48 weeks of Interferon/ribavirin therapy without contingency management.
Genotype 2&3
All patients will be followed up 12 and 24 weeks after treatment to check if the virus is still cleared and will be followed up annually to determine re-infection rate for the duration of the study. For up to 4 years.Participants will be followed up weekly for up to 24 weeks with weekly treatment injections & given a week’s supply of medications. They may be followed up until 2017 when the active patient follow up study ends. The outcomes will be the success of treatment in this group of patients and the impact it has on the population prevalence of HCV.Information from: Eradicate Hep C – Patient Information Leaflet V3.0 7th March 2014Treated with
1) PEGInterferon Alpha2) Weight based ribavirin If the patient clears the virus within 4 weeks they will receive 16 weeks therapy, if not they will receive 24 weeks.Slide13
We cannot solve our problems with the same thinking we used when we created them.
Albert Einstein
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