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The "Scanvir" concept aims to achieve barriers to HCV screening and treating of marginalized patients. The concept is applicable to other various populations and territories and should effectively improve HCV patient's health outcomes. The main objective of the SCANVIR project was to evaluate the feasibility, acceptability and reproducibility of a "test, treat and cure" strategy for PWIDs and vulnerable populations during dedicated days in addiction care centers.
According to the French recommendations, eliminating hepatitis C virus by 2025 could be a realistic public health goal in this country. A total of 71,466 patients had treatment initiation between 2015 and 2019. It is estimated that 100 000 people are still infected in 2019.
To meet these ambitious objectives, effective screening policies should be intensified and access to treatment promoted through new care strategies for patients who escape the usual care pathways i.e. people who inject drugs (PWIDs), prisoners, migrants and vulnerable populations.
PWIDs represent a large proportion of patients to be screened and treated. It's still not possible to accurately evaluate the number of drug users who are infected with HCV (45 000 people estimated).
Drug users sharing needles and syringes have poor access to treatment. Dealing with PWIDs in addiction care centers (CSAPA and CAARUD in France) is one way to promote HCV testing, and to keep them in the care pathway. This population requires dedicated models that reduce barriers to care: harm reductions policies, access to therapy in real time and follow-up for the detection of reinfection. So the investigator designed and applied a new innovative concept to test, treat and cure PWIDs in their own environment, called the SCANVIR program, initially tested in four French departments with a regional and now national extension.
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| Measure | Description | Time Frame |
|---|---|---|
| Evaluate the acceptability and the feasibility of simultaneous screening for viral hepatitis B, C and HIV among drug users and vulnerable populations in non-conventional structures using a triple method with RTD and FibroScan® and GeneXpert®. | Feasibility will be assessed by the number of days and the number of participants in all sessions. the acceptability of TROD and/or Fibroscan will be assessed by the number and proportion of double screenings (TROD and/or Fibroscan) performed in relation to the number of screenings offered | from enrollment to the end of the subject participation at the end of the day |
| Measure | Description | Time Frame |
|---|---|---|
| Reinforce screening for hepatitis B (HBV), hepatitis Delta (HDV) and HIV, | Number and proportion of patients who accepted immediate consultation with the hepatologist, | from enrollment to the end of the subject participation at the end of the day |
| Reinforce education to prevent the risk of viral transmission, |
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Inclusion Criteria:
Exclusion Criteria:
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drug users and vulnerable populations in non-conventional structures
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marilyne DEBETTE-GRATIEN, MD | Contact | +33555056604 | marilyne.gratien@chu-limoges.fr |
| Name | Affiliation | Role |
|---|---|---|
| marilyne DEBETTE-GRATIEN, MD | University Hospital, Limoges | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Limoges University Hospital | Recruiting | Limoges | 87000 | France |
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Number and proportion of patients who accepted risk prevention education by the nurse |
| from enrollment to the end of the subject participation at the end of the day |
| Encourage HBV vaccination, | Number of HBV vaccinations offered, | from enrollment to the end of the subject participation at the end of the day |
| Evaluate the feasibility of PCR (GeneXpert/Buvard), | Number of GeneXpert PCRs performed, Number of PCRs performed on blotting paper, | from enrollment to the end of the subject participation at the end of the day |
| Reinforce education to prevent the risk of viral transmission, | Number and proportion of patients who have accepted risk prevention education from the nurse, | from enrollment to the end of the subject participation at the end of the day |
| Provide social support, | Number of patients who received social support, | from enrollment to the end of the subject participation at the end of the day |
| Offer rapid treatment to HCV-positive patients in precarious situations, | Absolute number and proportion of patients treated or not maintained in care, | from enrollment to the end of the subject participation at the end of the day |
| Assess associated co-morbidities: alcohol, cannabis, drug misuse, associated psychiatric pathologies, | Number of patients with one or more risk factors for chronic liver disease, whether or not associated with chronic viral hepatitis or HIV infection: alcohol, metabolic syndrome, cannabis, drugs detected by FibroScan ®. | from enrollment to the end of the subject participation at the end of the day |