Hepatitis c virus microelimination in centers for addiction treatment users during COVID-19 pandemic

Background: To eliminate hepatitis C infection is necessary to implement protocols in high prevalence but low adherence populations, like the centers for addiction treatment users (CAT). We have previously reported high sustained viral response in this population with the Fast-Track Consultation Protocol (FT). COVID-19 pandemic (C19) has elicited to modifications of the health assistance and, consequently, HCV elimination. The aim of this study is to analyse the differences in diagnosis, adherence and response to HCV treatment in CAT users after the onset of C19. Methods: FT include screening and treatment supervision in CAT and hospital assistance in a single day (diagnosis and prescription). During pandemic, telemedicine and treatment dispensation at CAT were started. Demographic, clinical variables, adherence to treatment and sustained viral response were included. Differences between pre-COVID19 pandemic (pC19) (March 2019 to February 2020) and COVID pandemic (C19) (March 2020 to February 2021) in terms of sustained viral response were analysed by using non-parametric tests. Results: No significant differences between the two studied groups were identified in demographic and clinical variables and, interestingly, in the prevalence of active drug consumption or the presence of psychiatric disorders (table 1). During pC19, 390 patients were included and 33% were HCV positives;during C19, 115 patients were included (11% HCV positives). 139 patients started treatment in pC19, while 41 patients were treated during the C19 (8 were on treatment at the time of this analysis). 90.6% and 93.8% patients completed the treatment in pC19 and C19, respectively (p=.440). Sustained viral response was achieved in 90.6% of patients and 87.9% of patients in the pC19 and C19 groups, respectively (p=.632). Conclusion: Hepatitis C virus elimination in CAT users has been feasible during C19 by adapting the FT protocol. It has achieved similar rates of adherence to treatment and sustained viral response than in the pC19 and is not affected by basal vulnerability conditions.