hepatitis c needs assessment:
DESCRIPTION
Hepatitis C Needs Assessment:. Contributions from the National HCV Diagnosis and Local Clinical Databases. Key questions. How many people have been diagnosed with HCV in Scotland? How many people have attended a clinic for HCV treatment/care? - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/1.jpg)
Hepatitis C Needs Assessment:
Contributions from the National HCV Diagnosis and
Local Clinical Databases
![Page 2: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/2.jpg)
Key questions
1. How many people have been diagnosed with HCV in Scotland?
2. How many people have attended a clinic for HCV treatment/care?
3. How many people have been initiated on HCV antiviral therapy?
4. How many patients have cleared HCV from antiviral therapy?
![Page 3: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/3.jpg)
1. How many people have been diagnosed with HCV in Scotland?
![Page 4: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/4.jpg)
Annual and cumulative HCV diagnoses in Scotland (to 2006)
0
500
1000
1500
2000
2500
3000
3500
4000
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Year of HCV diagnosis
Ne
w H
CV
dia
gn
os
es
0
5000
10000
15000
20000
25000
Cu
mu
lati
ve
HC
V d
iag
no
se
s
![Page 5: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/5.jpg)
Characteristics of HCV diagnosed persons in Scotland(2003-2006, N = 6442)
• 66% male
• 22% 40 years at diagnosis; mean age = 34
• 90% current/former injecting drug users
• 55% genotype 2/3
• 50% of referrals were from hospitals,24% from GPs, 6% GUM, 3% prisons
![Page 6: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/6.jpg)
Cumulative HCV diagnoses by NHS Board in Scotland(to 2006)
Lothian 14%
Tayside 7%
Grampian 12%
Greater Glasgow & Clyde 41%
N = 22,073
0–249
250–749
750–1499
1500–4999
5000+
![Page 7: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/7.jpg)
1. How many people have been diagnosed with HCV in Scotland?
2. How many people have attended a clinic for HCV treatment/care?
![Page 8: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/8.jpg)
0–249
250–749
750–1499
1500–4999
5000+
Locations of 16 HCV treatment/care centres
Treatment centre
N = 22,073
Number of diagnoses
![Page 9: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/9.jpg)
Locations of HCV treatment/carecentres in relation to the HCV diagnosed population
• Mean drive-time of 20 min. from HCV diagnosed person’s place of residence (postcode district) to the nearest HCV treatment/care centre.(range 10-80 min. for NHS Boards in mainland Scotland)
![Page 10: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/10.jpg)
Numbers of diagnosed HCV attending HCV treatment/care centres(to 2006)
Diagnosed HCV antibody positive: 22,073
Diagnosed with chronic HCV (est.): 16,500
Attended specialist services for chronic HCV (est.): 9,000
Diagnosed with chronic HCV (est.): 14,500
Ever chronic HCV and ever attended specialist services (est.): 8,000
Approximately 55% of persons living with diagnosed chronic HCV have ever been in
specialist care
Living+
dead
Living
![Page 11: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/11.jpg)
New attendees at HCVtreatment/care centres(2003-2006, 5 clinics, N = 1202)
• 70% male
• 38% 40 years at first attendance; mean age = 38
• 78% current/former injecting drug users
• 52% of referrals were from hospitals, 28% from GPs
• 92% PCR positive
![Page 12: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/12.jpg)
New attendees at HCVtreatment/care centres(2000-2005, 5 clinics, N = 1677)
• 2000-2005: 73% increase in new patients (range 16-174%, 5 clinics)
![Page 13: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/13.jpg)
Follow-up of new patients attending HCV treatment/care centres(2003-2005, 5 clinics, N = 964)
Assessed for Rx57% (32-70%)
New attendeesN=964
Not assessed for Rx43%
Most common reason is failure to attend
![Page 14: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/14.jpg)
Follow-up of new patients attending HCV treatment/care centres(2003-2005, 5 clinics, N = 964)
Assessed for Rx57% (32-70%)
New attendeesN=964
Not assessed for Rx43%
Not suitable for Rx
32% (17-76%)
Most frequent:• ongoing IDU• chaotic lifestyle
![Page 15: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/15.jpg)
Follow-up of new patients attending HCV treatment/care centres(2003-2005, 5 clinics, N = 964)
Assessed for Rx57% (32-70%)
New attendeesN=964
Not assessed for Rx43%
Suitable for Rx68% (23-82%)
Approximately 20% refused or deferred the offer
![Page 16: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/16.jpg)
Follow-up of new patients attending HCV treatment/care centres(2003-2005, 5 clinics, N = 964)
Assessed for Rx57% (32-70%)
New attendeesN=964
Not assessed for Rx43%
Suitable for Rx68% (23-82%)
Approximately 30% of new attendees began therapy
Not suitable for Rx
32% (17-76%)
![Page 17: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/17.jpg)
1. How many people have been diagnosed with HCV in Scotland?
2. How many people have attended a clinic for HCV treatment/care?
3. How many people have been initiated on HCV antiviral therapy?
![Page 18: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/18.jpg)
Numbers of HCV diagnosed persons initiated on antiviral therapy(to 2006)
Diagnosed HCV antibody positive: 22,073
Diagnosed with chronic HCV (est.): 16,500
Attended specialist services for chronic HCV (est.): 9,000
Initiated on antiviral therapy (est.): 2,300
Living+
dead
Approximately 14% of persons who have ever been diagnosed with chronic HCV have been
initiated on antiviral therapy
![Page 19: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/19.jpg)
Patients initiated on HCV antiviral therapy (2003-2006, 5 clinics, N = 353)
• 71% male
• 57% 40 years at initiation; mean age = 41
• 56% injecting drug users
• 62% genotype 2/3
• 12% known to have cirrhosis
• 92% pegylated interferon +/- ribavirin
![Page 20: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/20.jpg)
Patients initiated on HCV antiviral therapy (2000-2005, 5 clinics, N = 678)
• 2000/1 to 2004/5: 117% increase in number of patients initiating therapy (range 50-208%, 5 clinics)
![Page 21: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/21.jpg)
Key questions
1. How many people have been diagnosed with HCV in Scotland?
2. How many people have attended a clinic for HCV treatment/care?
3. How many people have been initiated on HCV antiviral therapy?
4. How many patients have cleared HCV from antiviral therapy?
![Page 22: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/22.jpg)
Response to antiviral therapy (2003-2006, 5 clinics, N = 286)
• 46% sustained viral response
• 43% no sustained viral response
• 11% incomplete
– major side effect: 52%– patient request: 30%– other: 18%
![Page 23: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/23.jpg)
Current capacity of HCV treatment/care centres (2006)
Number of patients attending HCV treatment/care centres in 2006: 4,000
Number of patients initiated on antiviral therapy in 2006 (est.): 450
Number of patients currently on waiting list for therapy (est.): 330
![Page 24: Hepatitis C Needs Assessment:](https://reader033.vdocuments.net/reader033/viewer/2022061610/568139ce550346895da17e71/html5/thumbnails/24.jpg)
Summary
• Estimated that 55% of people living with chronic HCV have ever attended specialist services
• Estimated that 14% of those with diagnosed HCV have ever initiated therapy
• Annual numbers of new attendances and therapy initiations are increasing
• Low completion of assessment (57%) isan impediment to treatment