To evaluate the effectiveness of an opportunistic outreach fibroscanning service to a community based drug treatment clinic in Dublin

First published: 10/05/2019 | Last updated: May 20th, 2019

Aims: To evaluate the effectiveness of an opportunistic fibroscanning service to a community based drug treatment clinic in Dublin in assessing the level of liver disease in those attending the clinic who were identified as having chronic HCV infection.

Design

Setting

Addiction treatment centre in Inner City Dublin providing opioid substitution treatment (OST) to over 300 people.

Participants

80 patients who were HCV antigen/PCR positive.

Measurements

Fibroscan score.

Findings

73 (91%) patients attended for fibroscan. The fibroscan scores ranged from 3.6- 48.0 kpa. 40% (n=29) scored > 8.5 kpa (national DAA treatment eligibility criteria). Higher fibroscan scores (> 8.5) were associated with current or previous problematic alcohol use and being diagnosed more than 10 years (n=67%). 87.5% (n= 25) had previously been referred for secondary follow up but had failed to attend.

Conclusions

Community fibroscanning provides an opportunity to identify those at highest risk of advanced liver disease and has a high acceptability among OST patients. It provides the opportunity to identify those eligible for DAAs treatment and by eliminating the need for liver biopsy and providing this assessment at their local treatment clinic is eliminating some of the identified barriers to accessing HCV treatment in this patient cohort.

Co-Authors

Dr D Crowley1, Ms C Murphy2, Ms T McHugh2, Mr J Farrell 2, Dr S Stewart 2, Dr Geoff McCombe2,3, Dr Aoife Cotter2, Dr J.S. Lambert2, 1 The Thompson Centre, HSE Addiction Services Dublin, Ireland 2 Centre for Infectious Diseases Research, Catherine McAuley Centre, Mater Misericordiae University Hospital; Dublin, Ireland 3 UCD School of Medicine


Conflicts of interest:

Funding Sources: n/a

no conflict of interest

Dr Geoff McCombe