{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T20:42:19Z","timestamp":1776285739147,"version":"3.50.1"},"reference-count":116,"publisher":"SMW Supporting Association","issue":"4950","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Swiss Med Wkly"],"abstract":"<jats:p>BACKGROUND: In opioid agonist therapy (OAT) programmes, chronic hepatitis C is highly prevalent and directly observed therapy guarantees optimal adherence. Since 2017, all patients with chronic hepatitis C in Switzerland can be treated with pangenotypic direct-acting antivirals irrespective of liver fibrosis stage. Until the end of 2021, however, prescription was restricted to infectious disease specialists, gastroenterologists and certain addiction specialists. Difficult venous access after long-term intravenous drug use and, in the case of referral to a specialist, difficulties keeping appointments are barriers to HCV diagnosis and treatment.\nAIMS: To assess whether minimally invasive point-of-care tests and a \u201ctest-and-treat \/ vaccinate on-site\u201d approach can improve human immunodeficiency virus (HIV) \/ hepatitis C virus (HCV) screening, HCV treatment uptake and immunity against hepatitis A\/B.\nMETHODS: Since September 2018, an infectious disease specialist and a study nurse performed 4-weekly visits in the OAT programme \u201cHAG\u201d (heroin dispensation of the canton Aargau), offering HIV\/HCV antibody rapid testing (20 min) and HCV RNA quantification (GeneXpert\u00ae, 60 min) from capillary blood, noninvasive liver fibrosis assessment (Fibroscan\u00ae, 5\u201310 min) and HCV treatment prescription on-site. Recommended venous blood draws for HAV\/HBV serology and HAV\/HBV vaccinations were performed by the staff of the \u201cHAG\u201d. Project performance was assessed by annual cross-sectional chart review.\nRESULTS: Of the 128 patients registered in April 2018, 79 (62%) were still present in May 2021. With 72 newly registered, a total of 200 patients could be assessed, of whom 129 (65%) were still present in May 2021. Between April 2018 and May 2021, the proportion ever tested for HIV antibodies increased from 79% (101\/128) to 91% (117\/129), the proportion ever tested for HCV antibodies from 83% (106\/128) to 93% (120\/129) and the proportion of those HCV antibody positive ever tested for HCV RNA tested from 89% (47\/53) to 98% (56\/57). The proportion with adequate HCV management (last HCV antibody test \u22641 year ago, if HCV antibody negative or last HCV RNA test \u22641 year ago, if HCV antibody-positive and RNA-negative) improved from 23% ([15 + 15]\/128) to 80% ([55 + 48]\/129). Overall, HCV treatment uptake increased from 60% (21\/35) to 92% (55\/60) and HCV RNA prevalence among the HCV antibody positives decreased from 38% (18\/47) to 7% (6\/84). Between 2018 and 2021, 19 non-cirrhotic chronic hepatitis C patients were successfully treated on-site (18 sustained virological responses [SVR] 12, 1 SVR4), with excellent adherence (\u226593%) and, so far, no reinfection. The proportion with known HAV\/HBV serostatus increased from 38%\/51% to 64%\/76%. Immunity against HAV\/HBV improved from 19%\/23% to 50%\/57%.\nCONCLUSION: Capillary blood point-of-care tests and a \u201ctest-and-treat \/ vaccinate on-site\u201d approach remove crucial barriers to diagnosis and treatment, making hepatitis elimination in OAT programmes achievable. A high fluctuation rate requires HIV\/HCV\/HAV\/HBV testing at admission, but also allows more patients to be screened.<\/jats:p>","DOI":"10.57187\/smw.2022.40009","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:31:06Z","timestamp":1670891466000},"page":"40009","source":"Crossref","is-referenced-by-count":5,"title":["HCV elimination in a Swiss opioid agonist therapy programme  \u2013 a cohort study"],"prefix":"10.57187","volume":"152","author":[{"given":"Andrea","family":"Bregenzer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia","family":"Krismer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefanie","family":"Wendel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrik","family":"Roser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph A.","family":"Fux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"36756","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"key":"79708","unstructured":"Richard JL, Schaetti C, Basler S, M\u00e4usezahl M. 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Available from: https:\/\/www.bag.admin.ch\/dam\/bag\/de\/dokumente\/npp\/sucht\/hegebe\/substitutionsgestuetzte-behandlungen-bei-opioid-abhaengigkeit.pdf.download.pdf\/BAG_Brosch_SGB_d(5)_def.pdf (Accessed: 9 June 2022)"},{"key":"79714","unstructured":"Bundesamt f\u00fcr Gesundheit (BAG). Substitutionsgest\u00fctzte Behandlungen bei Opioidabh\u00e4ngigkeit (9.3.2022). Available from: https:\/\/www.bag.admin.ch\/bag\/de\/home\/gesund-leben\/sucht-und-gesundheit\/suchtberatung-therapie\/substitutionsgestuetzte-behandlung.html (Accessed: 9 June 2022)"},{"key":"79715","unstructured":"Cominetti F, Simonson T, Dubois-Arber F, Gervasoni JP. IUMSP, Schaub M., ISGF, Monnat M., SSP. Analyse der Hepatitis-C-Situation bei den drogenkonsumierenden Personen in der Schweiz. Lausanne, Institut universitaire de m\u00e9decine sociale et pr\u00e9ventive, 2014. 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