Viral Hepatitis Service, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Hepatitis C Trust, Southwark, UK.
J Viral Hepat. 2023 Dec;30(12):922-925. doi: 10.1111/jvh.13888. Epub 2023 Sep 18.
Chronic Hepatitis C virus (HCV) infection is a major cause of morbidity and deaths worldwide. HCV treating teams are working toward the goal of eliminating HCV by 2030. People who inject drugs (PWIDs) are at high risk of HCV but contact tracing is not routine practice. Here, we present the outcomes of a HCV 'test, trace and treat' pilot using peer workers to test contacts of individuals with HCV. PWIDs with HCV were invited to participate when they presented for treatment. For those agreeing to participate, a peer approached them to invite potential contacts for HCV testing. Data were collected on uptake, HCV test results, treatment rates and reasons for declining. Overall, 295 individuals (162 recent HCV [<1 year], 69 reinfections, 64 known chronic HCV) were invited to participate, of whom 147 (50%) agreed and 30 (20% of those agreeing) brought forward 120 contacts for testing. Of these, 44 (37%) were HCV RNA positive, including 23 who were not known to services. 34 (77%) started antiviral treatment. HCV RNA positivity was highest in contacts of reinfections (45%) compared with recent HCV (33%) and known chronic HCV (25%). The most common reason for index individuals declining participation was that they reported no longer being in contact with individuals from their injecting network (65%). In conclusion, half of PWIDs with HCV agreed to participate in the pilot, but only 20% of these brought contacts forward. The frequency of active HCV was high in the contacts and the majority started antiviral treatment.
慢性丙型肝炎病毒 (HCV) 感染是全球发病率和死亡率的主要原因。HCV 治疗团队正在努力实现到 2030 年消除 HCV 的目标。注射毒品者 (PWIDs) 感染 HCV 的风险很高，但接触者追踪并非常规做法。在这里，我们展示了使用同伴工作者对 HCV 感染者的接触者进行“检测、追踪和治疗”试点的结果。当 PWIDs 因 HCV 就诊时，邀请他们参加 HCV 检测。对于同意参加的人，同伴会接近他们，邀请潜在的接触者进行 HCV 检测。收集了参与情况、HCV 检测结果、治疗率和拒绝原因的数据。共有 295 人（162 人为近期 HCV [<1 年]，69 人为再感染，64 人为已知慢性 HCV）受邀参加，其中 147 人（50%）同意，30 人（同意人数的 20%）带了 120 名接触者进行检测。其中，44 人（37%）HCV RNA 阳性，包括 23 人未被服务机构发现。34 人（77%）开始接受抗病毒治疗。再感染接触者的 HCV RNA 阳性率最高（45%），高于近期 HCV（33%）和已知慢性 HCV（25%）。指数个体拒绝参与的最常见原因是他们报告不再与来自他们注射网络的个人接触（65%）。总之，一半的 HCV 感染 PWIDs 同意参加试点，但只有 20%的人带接触者进行了检测。接触者中活跃 HCV 的频率很高，大多数人开始接受抗病毒治疗。
