Verbetering van de opsporing van hepatitis C in de verslavingszorg

Samenvatting Het doel van het onderzoek, uitgevoerd door De Regenboog Groep, Stichting Mainline en GGD Amsterdam, is het opsporen van hepatitis C (HCV) onder cliënten van de Maatschappelijke Opvang (MO) in Amsterdam. Aan cliënten van veertien MO-locaties werd in de periode augustus-december 2017 gevraagd een risicochecklist in te vullen en zich te laten testen op hepatitis C-antilichamen (anti-HCV) door middel van een oral swab. Bij een positieve uitslag werd HCV-RNA getest. Uit de zelfrapportage van 233 cliënten blijkt dat 90 % risico heeft gelopen op HCV. Getest zijn 225 cliënten, van wie 22 (9,8 %) anti-HCVpositief, onder wie 10 (4,4 %) HCV-RNA-positief. Er is hoge uitval (50 %) tussen het testen op anti-HCV en de behandeling. Prevalentie van anti-HCV in deze doelgroep is aanzienlijk hoger dan de prevalentie van anti-HCV in Nederland (9,8 % versus 0,2-0,4 %). De doelgroep behoort dus tot een risicogroep voor HCV en moet volgens het advies van de Gezondheidsraad worden opgespoord. Aanbevolen wordt om onmiddellijk na een positief anti-HCV-resultaat, HCV-RNA op locatie te testen en gebruik te maken van tests met vingerprikbloed.

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Hepatitis C: van testen tot behandelen

Grient¹,

Warmoeskerken²,

Woerden

et al. 2019

TSG Tijdschr Gezondheidswet

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A Feasibility Study to Increase Chronic Hepatitis C Virus RNA Testing and Linkage to Care among Clients Attending Homeless Services in Amsterdam, The Netherlands

Grient¹,

Schatz²,

Santen

et al. 2021

Diagnostics

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People who inject drugs (PWID) are disproportionately affected by hepatitis C virus (HCV) infections and are frequently homeless. To improve HCV case finding in these individuals, we examined the feasibility of rapid HCV RNA testing in homeless services in Amsterdam. In 2020, we provided a comprehensive service to homeless facilities, which included workshops on HCV for personnel, a “hepatitis ambassador” at each facility, a rapid, onsite HCV RNA fingerstick test service, and assistance with linkage to care. Risk factors for HCV RNA-positive status were examined using Bayesian logistic regression. Of the 152 participants enrolled, 150 (87% men; median age: 47 years) accepted rapid HCV testing. Seven tested HCV RNA positive (4.7%, 95%CrI = 1.31–8.09; 7/150). Of these, five (71%) were linked to care, of whom four (57%, 4/7) initiated treatment and one (14%, 1/7) delayed treatment due to a drug–drug interaction. Of these four people, two completed treatment (50%), of whom one (25%) achieved sustained virologic response after 12 weeks. HCV RNA-positive individuals were more likely to originate from Eastern Europe (posterior-odds ratio (OR) = 3.59 (95% credible interval (CrI) = 1.27–10.04)) and to inject drugs (ever: posterior-OR = 3.89 (95% CrI = 1.37–11.09); recent: posterior-OR = 3.94 (95% CrI = 1.29–11.71)). We identified HCV RNA-positive individuals and linkage to care was relatively high. Screening in homeless services with rapid testing is feasible and could improve HCV case finding for PWID who do not regularly attend primary care or other harm reduction services for people who use drugs.

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Verbetering van de opsporing van hepatitis C in de verslavingszorg

Cited by 2 publications

References 3 publications

Hepatitis C: van testen tot behandelen

Hepatitis C: van testen tot behandelen

A Feasibility Study to Increase Chronic Hepatitis C Virus RNA Testing and Linkage to Care among Clients Attending Homeless Services in Amsterdam, The Netherlands

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