Towards hepatitis C elimination in France: Scanvir, an effective model to test and treat drug users on dedicated days

Abstract

According to the French recommendations, the elimination of the hepatitis C virus by 2025 could be a realistic public health goal. Screening policies are being intensified, and access to treatment is promoted for patients who escape the usual care pathway.The 'Scanvir' program is an original strategy based on dedicated screening days, as part of the 'test, treat and cure HCV' event in addiction care centers in a French region, during which innovative screening technologies (RDTs, FibroScan® and pointof-care HCV RNA testing) are brought on site and access to a multidisciplinary team is offered. A total of 392 patients attended the 67 regional Scanvir sessions: 31.6%were HCV Ab-positive and 66% of them were HCV RNA-positive. Treatment was initiated in 79.3% of the patients. RDTs were accepted by 62% of the PWIDs (including those who already knew their status) and FibroScan® by 99.5% of the patients. 80% of the viremic patients started their treatment on site and are now cured or still under treatment. Advanced fibrosis evaluated by FibroScan® (LSM > 8 KPa) was suspected in 13.4% and 14.1% of the global and the HCV population, respectively. Scanvir is an efficient strategy for HCV elimination based on dedicated days aimed at increasing cost-effectiveness and offering a multidisciplinary service while saving human care resources. It is an exportable strategy that also offers comprehensive screening of associated chronic liver diseases via the elastometry device and interviews.

Non-disclosure of drug injection practices as a barrier to HCV testing: results from the PrebupIV community-based research study

“…A recent meta-analysis found that the use of onsite POC RNA viral load had a positive impact on reduced turnaround times between HCV antibody testing and treatment initiation, and on testing and treatment uptake for PWID, especially when it was proposed at the same visit and on the same day [ 35 ]. In France, a recent study demonstrated the feasibility and acceptability of a ‘test and treat’ strategy based on dedicated screening days, proposing both HCV antibody and RNA testing in addiction care centers [ 36 ]. More generally, combining ‘test and treat’ strategies, linkage to care and early treatment initiation, would be a cost-effective option for reducing HCV incidence and improving PWID life expectancy in the French context [ 37 ].…”

Impact of Public Policy and COVID-19 Pandemic on Hepatitis C Testing and Treatment in France, 2014–2021

“…Consequently, the identification of patients requiring treatment has become a challenging task that requires specific time-consuming interventions. In recent years, many interventions have been conducted in France with this goal, such as recontacting former patients not treated by DAAs and lost to follow-up by hepatology wards [32], or one-off screening interventions to enhance testing, linkage to care, and treatment initiations in the general population [33], at-risk populations [34,35], and in other countries [36]. In addition to screening and linkage to care, elimination efforts should also focus on infection and reinfection prevention measures.…”