Duración

2020-2022

Coordinador

Jeffrey Lazarus (ISGlobal)

Financiadores

Gilead Sciences HCV-STAT Programme

The objective of this study is to eliminate hepatitis C virus (HCV) in the autonomous community of the Balearic Islands using the micro-elimination approach. The project aims to reach patients with a history of drug use who are treated in the different governmental and non-governmental addiction service centres, a mobile methadone unit, or are in prison, in order to test and link people who use drugs to HCV care.

The purpose of this project is to diagnose and treat hepatitis C in this key population group with a new model of care that simplifies the current diagnosis process and facilitates linkage to care and subsequent treatment initiation.

In the different addiction services centres (Unitats de Conductes Addictives; UCAs), patients will be screened for HCV using a saliva-based rapid detection test (Oraquick®, Orasure Technologies Inc.,) to detect the presence of HCV antibodies (HCV Ab) followed by a dried blood spot (DBS) sample to confirm viremia (HCV-RNA). Treatment will be prescribed by a hepatologists to those patients who are positive for the infection via telemedicine and will be delivered and administered at the same addiction services centres. To confirm the completion of treatment and sustained virologic response (SVR), in addition to possible reinfections, monitoring utilizing DBS will be carried out for up to a year after treatment completion.

The project commenced its testing activities in April 2021 and has been implemented in the 17 target study sites, 12 are in place in the Island of Mallorca, two in Ibiza and three in Menorca. As of November 2022, 1050 people have been tested, of which 12% (n=129) had an active hepatitis C infection (HCV-RNA+). Of those, 86% (n=111) have started treatment and 71% (n=92) of them have already finished it.

Photo: Andrea Herranz. Poster of the project in one of the addiction services centres (UCA).

Photo: Andrea Herranz. Health staff from Projecte Home (non-governmental addiction service centres) explaining the project to a participant.

This project is led by the ISGlobal Health Systems Research group in collaboration with Hospital Universitari Son Llàtzer, Hospital Universitari Son Espases, Hospital Comarcal d’Inca, Hospital Comarcal de Manacor (Mallorca), Hospital General Mateu Orfila (Menorca), Hospital Can Misses (Ibiza), Hospital Vall d’Hebron (Barcelona) and is funded through the competitive research call HCV STAT, by Gilead Sciences.

Abstracts

• Eliminating hepatitis C on the Balearic Islands by linking patients who use drugs from addiction service centers, a local NGO, a prison and a mobile methadone bus to HCV care. JV Lazarus et al. HepHIV Conference, May 2021.  
• A new model of care for hepatitis C launched after 1 year of the COVID-19 pandemic in the Balearic Islands: first results. JV Lazarus et al. INHSU 2021 conference.
• Eliminando la hepatitis C en las Islas Baleares: intervención en Projecte Home Balears. Socidrogalcohol 2021.
• Eliminating hepatitis C in the Balearic Islands, Spain: a study in governmental and non-governmental addiction service centres to test and link people who use drugs to HCV care. IVHEM 2021.
• HCV micro-elimination strategies for the PWUD population of the Balearic Islands. EASL Hepatitis monothematic 2022.
• Nuevo modelo de atención para la micro eliminación de la hepatitis C en PWUD de las Islas Baleares. 47º congreso AEEH 2022.
• A new model of care for HCV elimination in PWUD in the Balearic Islands, Spain. INSHU 2022.
• Hepatitis C Free Balears: a micro-elimination program focused on people who use drugs in the Balearic Islands, Spain. IVHEM 2022.

Papers

• Lazarus JV, Herranz A, Picchio CA, Villota-Rivas M, Rodríguez A, Alonso JM, Moratinos A, Perrotta A, Tegeo E, Bibiloni F, Buti M, Vilella À. Eliminating hepatitis C on the Balearic Islands, Spain: a protocol for an intervention study to test and link people who use drugs to treatment and care. BMJ Open. 2021 Oct 21;11(10):e053394. doi: 10.1136/bmjopen-2021-053394. PMID: 34675021; PMCID: PMC8532552. pubmed.ncbi.nlm.nih.gov/34675021.