Members of the Viral Hepatitis Research Program and partners at the Hope to Health Centre for World Hepatitis Day
July 28th was World Hepatitis Day, an annual, purposeful opportunity to raise awareness of the global burden of viral hepatitis and to spark action. This year’s theme is ‘I Can’t Wait’, which highlights the urgency from the global community to improve access to life-saving treatments. Around the world, every 30 seconds someone dies from a hepatitis related illness, despite the fact that the hepatitis C virus (HCV) is now generally considered a curable disease. Relatively new and well-tolerated direct-acting antivirals (DAAs) have a cure rate of 95 percent, however, there are still significant barriers to get treatment to those in need.
Using its proven Treatment as Prevention strategy, the BC-CfE is raising awareness of HCV and its treatment in several ways. Most recently, the BC-CfE launched Hep C Connect, a pilot project funded by Gilead Sciences. Started in November 2021, it provides nurse-led, low barrier HCV testing, education, and linkage to care to clients of the Hope to Health (H2H) supervised consumption site located at 611 Powell Street.
Beyond testing, the overarching aim of Hep C Connect is to enhance linkage to care and retention amongst unattached and underserved clients diagnosed with HCV in the Downtown East Side (DTES). Clients are offered rapid antibody testing and, if positive, same day, in-house, confirmatory HCV RNA testing. Pre- and post-test counselling, as well as follow-up and linkage to care is provided by an LPN. Hep C Connect provides a unique integration of HCV related services including low-barrier HCV education, community-based harm reduction services, and in house, same day testing, reducing barriers which often discourage people, especially in the DTES, from accessing lifesaving HCV treatment.
As of this month, Hep C Connect has served a total of 148 clients; 51 of which had no existing attachment to primary care; 51 tested for HCV RNA with 24 clients who tested positive for HCV RNA, 5 of which have begun treatment. The program recently expanded to serve a higher volume of clients and extend the length of follow up from 6 to 12 months.
Clinical Research Coordinator, Shaughna Cooper, with the BC-CfE’s Viral Hepatitis Research Program (VHRP) said, “While clients may be coming to the H2H supervised consumption site primarily to access harm reduction supplies or consume drugs in a safe environment, Hep C Connect provides them with the ability to connect with staff about HCV and to learn more about their status. Given the complexity of challenges clients are facing, HCV tends to get deprioritized in the face of more immediate concerns which is why it is crucial to have low barrier access to testing and treatment available.”
Cooper also said, “Our hope is that Hep C Connect and the evaluation research that is produced from it helps to demonstrate the need for a standard integration of harm reduction services and pathway to HCV care as there’s a dearth of similar programs at the moment.”
Per-SVR, short for PrEseRvation of Sustained Virologic Response, is another VHRP study and was launched in 2016 to evaluate the roll-out of DAAs in BC, following a request by provincial Ministry of Health. The Per-SVR study follows individuals who have recently cleared HCV following completion of DAA treatment and monitors their health outcomes, health care engagement, and reinfection events over time. This study will generate impactful data which will be important to tailor the provincial response to the HCV epidemic and, importantly, measure the impact on clients as well.
Phindile Tshabalala, a Clinical Research Coordinator with the VHRP said ‘The scope of the Per-SVR study extends beyond understanding the prevalence of HCV reinfections within marginalised and disenfranchised communities. This is a four-year, longitudinal study that identifies the societal factors influencing access to care and examines the acute influence of policy on the access, availability, and point-of-care treatment for underserved populations. Community-centred healthcare is the foundation on which the Per-SVR study operates.
Our relationship with participants goes far beyond the correlational, observational, and simple collection of data. We do this by building meaningful and long- standing relationships with our participants—the only way to ensure the continued improvement of health and wellbeing in our community. We try our best to provide consistent, accessible client care as it is essential to, and the only modality effective in, combatting HCV.’
To mark the day the VHRP team strengthened bonds with the community and raised awareness about HCV testing, treatment and its studies as well as the services offered at H2H providing lunch, refreshments and educational materials and naloxone training.
While clients may be coming to the H2H supervised consumption site primarily to access harm reduction supplies or consume drugs in a safe environment, Hep C Connect provides them with the ability to connect with staff about HCV and to learn more about their status. Given the complexity of challenges clients are facing, HCV tends to get deprioritized in the face of more immediate concerns which is why it is crucial to have low barrier access to testing and treatment available.
– Shaughna Cooper, Clinical Research Coordinator with the BC-CfE’s Viral Hepatitis Research Program (VHRP)