Hepatitis C screening pilot project at a tertiary care addictions services in Liverpool

First published: 10 May 2019 | Last updated: 20 May 2019

Aim

In England, data from the Unlinked Anonymous Monitoring (UAM) 2013 survey of people who inject drugs (PWID) found 50% tested positive for antibodies to HCV (anti-HCV).

After working closely with a Hepatitis Community Nurse, based at Brownlow Group Practice and Royal Liverpool Hospital, for many years on a client-by-client basis, we decided a year ago to set up a pilot Hepatitic C Mouth swab screening at community drug team site in the addictions service.

Methods

This was a retrospective cross sectional evaluation. We evaluated the data collected at this clinic to see how many mouth swab positive patient would go one to be PCR positive and eventually take up treatment

Results

We screened a total of 144 patients, out of which 86 (60%) were Hepatitis C mouth swab positive. Out of the 86 positive patients 16% were completely new diagnosis, 17.4% had cirrhosis on fibroscan, 10.4% had been referred for assessment to specialist Hepatitis C clinic and were on the waiting list, whilst 19.7% were either currently on or awaiting start of treatment. The rate of treatment is way above the national rate for Hepatitis C treatment uptake.

Conclusion:

It is apparent that the addictions services are one of the most important services to offer Hepatitis C screening, particularity PWID population. We have been running this pilot which shows really high uptake of treatment. The commissioners in the country should take note of the outcomes and consider funding full BBV services based and integrated in addictions services across the country.

Co-Authors

Jayne Wilkie, Senior Hepatitis Nurse, Royal Liverpool University Hospital Jodi Goss, Physical Health Nurse, Addictions Services, Mersey Care NHS Foundation Trust

Jayne Wilkie, Senior Hepatitis Nurse, Royal Liverpool University Hospital Jodi Goss, Physical Health Nurse, Addictions Services, Mersey Care NHS Foundation Trust

Qualified as a registered nurse in March 2003 at John Moores University.  After qualifying she worked on medical gastroenterology ward at the Royal Liverpool Hospital. In 2009 she moved to primary health care and worked within a General practice to assess needs of patients with hepatitis c within the hard to reach marginalized groups.  Her honorary contract enabled her to work within secondary health care at the Royal Liverpool hospital.

Jayne is now a Hepatology Nurse Specialist for the Royal Liverpool Hospital and continues to see hard-to-reach clients in the community with outreach clinics in the prison, GP Practice and local drug teams.


Conflicts of interest:

Funding Sources: Liverpool City Council

No conflict of interest

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Dr Yasir Abbasi