It is estimated that over 60,000 people have been exposed to hepatitis C virus (HCV) in BC, with approximately 2,000 new cases identified in the province each year. Many people living with a chronic hepatitis C infection are unaware of their status until symptoms appear.
Chronic HCV is often referred to as a “silent” disease because symptoms typically don’t appear until the liver is already severely damaged. Cirrhosis (liver scarring), liver failure, liver cancer, or the need for a liver transplant, can occur up to 30 years after onset of infection. For this reason, HCV testing and treatment is often deprioritized especially when patients are dealing with multiple competing comorbidities.
HCV is spread mainly through blood-to-blood contact and injection drug use is now the most common way the virus spreads in Canada, making up about 60 per cent of all new infections.
In order to know your HCV status, you have to have your blood tested. An HCV antibody test comes first, which, if positive, is followed by a PCR (polymerase chain reaction) test.
HCV treatments have changed dramatically from previous injection therapies which came with severe side effects and limited success. Current treatments take about eight to 12 weeks and involve only oral pills or tablets and have much fewer and less severe side effects. HCV treatment is also highly effective, with a cure rate of more than 95 per cent. Treatment is fully funded under BC’s PharmaCare as of 2018. However, the roll-out of this universal treatment program has not reached everyone in need, especially patients with more complex health and social issues.
Hep C Connect is a pilot project operating out of the BC-CfE’s Hope to Health (H2H) supervised consumption site (SCS). It offers rapid, low-barrier HCV testing and education, and also offers connections to primary care for clients who use drugs.
Launched in November 2021, with funding from Gilead Sciences, the goal of Hep C Connect is to enhance testing of HCV among unattached and under-served clients of a supervised consumption site in a low-barrier setting. The project also hopes to enhance linkage to care and retention for clients diagnosed with HCV through patient-centered, and nurse-led interventions. Clients can also participate in optional evaluation surveys which will help in measuring health outcomes and assessing care experiences across the HCV cascade of care.
From early November, 2021, up to late February, 2022, 125 participants were enrolled in Hep C Connect. Over 60% of participants tested positive for HCV antibodies and were offered confirmatory HCV RNA blood testing. The nurses at H2H continue to follow-up with clients who’ve tested positive for HCV and lack access to primary care. Primary Investigators are currently working to expand the program to serve a higher volume of clients, extend the length of follow up from six to 12 months and understand the system-level barriers that health care providers face in treating HCV in community settings.
The program has thus far been quite successful at reaching our target population of under-served or unattached clients. Over the past few months, we’ve talked to many participants that are very disengaged from healthcare or other psychosocial supports, and who report a complex set of health conditions including hepatitis C, addiction, and mental health issues.
– Shaughna Cooper, Hep C Connect Research Coordinator
Kirti Singh, a Licensed Practical Nurse at H2H, said, “Hep C Connect has allowed us to provide a low-barrier, judgement and stigma-free environment within which to engage clients about HCV. Clients are coming to the SCS to use the safe consumption services or access harm reduction supplies and Hep C Connect provides a pathway to HCV testing and treatment that they might otherwise miss in more traditional settings. We’re able to have conversations with people about their Hep C status and treatment options that are available to them.”