Year 2020 / Volume 112 / Number 7
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Year 2020 / Volume 112 / Number 7


Linkage to care strategy for the micro-elimination of hepatitis C among parenteral drug users on methadone replacement therapy in Gipuzkoa


Ylenia Pérez Castaño, José Manuel Chouza Pérez, Vanesa Sanz Largo, Edurne Almandoz Cortajarena, Alexandra Gómez García, Francisco Javier Esandi González, Agustín Castiella Eguzkiza, Sandra Arranz Díaz, Itxaso Urtasun Lugea, Maria José Sánchez Iturri, Borja Gil Fernández, Luis Bujanda, Juan Arenas Ruiz-Tapiador,

Introduction: parenteral drug users (PDUs) are a population with a high prevalence of infection with the hepatitis C virus (HCV) and significant difficulties to access to treatment. Opioid replacement therapy programs regularly monitor these individuals. Objective: to effectively treat this population using a directly observed therapy (DOT) and bringing resources closer to the methadone dispensing center in Gipuzkoa (Bitarte). Methods: all methadone users that were positive for anti-HCV antibodies were included in the study. Using a simplified circuit, a hepatologist visits the center with a Fibroscan® device and requests treatment following assessment. Treatment is dispensed at the addict center, under the supervision of a psychiatrist and nursing staff. Prevalence, population characteristics and circuit effectiveness were assessed. Results: Bitarte monitors 660 individuals. Of these, 73.6 % were positive for antibodies against HCV. The prevalence of viremic infection is 62.5 %. The predominant genotype was 1a, followed by 3. A total of 38.5 % had advanced fibrosis (F3 and F4) and 38 % of users admitted to active heroin use. In all, 82.07 % (174/212) of the population received treatment and 97 % had sustained viral response (SVR) after 12 weeks. No re-infections were recorded. Conclusions: the prevalence of viremic HCV infection among PDUs under treatment with methadone is 62 %. The linkage to care strategy was effective and > 80 % of the population with an active infection have been treated so far.

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Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
© 2020 The Spanish Journal of Gastroenterology