P-84 IMPLEMENTATION OF A STEP-BY-STEP STRATEGY BASED ON THE TREATMENT CASCADE TO ELIMINATE HEPATITIS C VIRUS INFECTION IN THE HOSPITAL CENTRAL DE LAS FUERZAS ARMADAS FROM URUGUAY. PRELIMINARY REPORT

Background Strategies to achieve the World Health Organization target of eliminating hepatitis C virus (HCV) infection by 2030 (diagnosis of 90% of chronically infected persons and treatment of 80%) are required. Objectives 1)  Determinate the status of HCV infection in the Hospital Central de las Fuerzas Armadas (HCFFAA) from Uruguay 2)  Implement and evaluate a step-by-step elimination strategy. Methods A treatment cascade was constructed by: A  Estimation of the number of HCV chronic infection population of the HCFFA based on Uruguay prevalence (0,7%) B  Analyzing medical records of the Hepatology service (2000–2020). The strategy consisted on contacting sequentially patients not cured: 1.  HCV RNA confirmed 2.  HCV antibody positive, RNA not tested Results 1.008 chronically HCV infected people were estimated. 165 HCV antibody positive persons were detected, 30 were excluded (RNA negative). Of the 135 left, 113 had RNA confirmation, 76 received treatments and 70 achieved sustained virological response (SVR). Of 6 persons without SVR, 3 are currently on treatment and 3 could not be contacted. Of 36 people RNA confirmed not treated, 20 were contacted: 10 were prescribed treatment and 10 were not candidate. Of 22 HCV antibody positive people without RNA confirmation, 10 were contacted and RNA was requested (results pending). Treatment prescription increased from 67 to 76% of HCV chronically infected RNA confirmed patients. Conclusion Strategy implementation was successful improving access to treatment. Active testing is the next step plan to overcome the barrier of patient unawareness of HCV infection.