2211. Hepatitis C Testing and Linkage to Care in a Public Health Setting in North Carolina: Addressing Gaps along the Care Continuum
Session: Poster Abstract Session: Hepatitis A, B, and C
Saturday, October 6, 2018
Room: S Poster Hall
  • IDWeek_HCV_TLC_Durham_ASena_2018.pdf (525.5 kB)
  • Background: Despite national recommendations in the United States (US) to conduct hepatitis C virus (HCV) screening among the birth cohort and high-risk populations, persons seeking public health services have limited access to care. We developed a HCV screening and linkage-to-care program at a public health facility in North Carolina (NC), and evaluated the HCV prevalence and care continuum.

    Methods: We collaborated with the Durham County Department of Public Health in Durham, NC to integrate routine HCV testing at the human services facility. Targeted screening with HCV antibody and reflex RNA was conducted based on US guidelines (e.g. birth cohort, intravenous drug use [IVDU]) in clinical areas and the department of social services. To support linkage to care, a “bridge counselor” or social worker assisted chronic HCV-infected persons with transportation, initial appointments with HCV specialists, and access to other services. We analyzed the HCV prevalence, risk factors, and the care continuum among this population.

    Results: From March 2016 to February 2018, targeted HCV screening was conducted among 2,775 persons, of which 84 (3%) were HCV antibody positive and RNA positive. Among persons identified with chronic HCV infection, the median age was 48.5 (interquartile range (IQR): 23-76), 48 (57%) were male, and 53 (63%) were African-American. HCV infected persons had multiple risk factors including past or current IVDU use (n=38, 45%), history of unlicensed tattoo/ear piercings (n=35, 42%), and prior incarceration (n=31, 38%); no HIV co-infections were identified. An assessment of the care continuum demonstrated that the majority with chronic HCV infection received post-test counseling (96%), met with the bridge counselor (70%) and attended their first medical appointment (74%). However, only 49% were prescribed HCV treatment and 24% achieved sustained virologic response.

    Conclusion: Implementation of targeted screening with HCV antibody and reflex RNA in a public health setting, coupled with bridge counseling, can identify persons with chronic HCV infections and link them to care. However, only half received HCV treatment and a fourth achieved HCV cure, highlighting the gaps in the care continuum where future interventions should be directed.

    Arlene Sena, MD, MPH1, Candice Givens, MSW2, Gwendolyn McKnight, BSPH2, Joseph Thayer, BA2 and Alison Hilton, MPH2, (1)Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, (2)University of North Carolina at Chapel Hill, Chapel Hill, NC


    A. Sena, Gilead Sciences: Grant Investigator , Grant recipient .

    C. Givens, Gilead Sciences: Grant support for salary , Grant recipient .

    G. McKnight, Gilead Sciences: Grant Investigator , Grant recipient .

    J. Thayer, Gilead Sciences: Grant Investigator , Grant recipient .

    A. Hilton, Gilead Sciences: Grant Investigator , Grant recipient .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.