Z Gastroenterol 2020; 58(05): e99
DOI: 10.1055/s-0040-1712312
Hepatologie

“Let’s end hepatitis C in Vienna” - the first HCV elimination program targeting homeless and people without medical insurance in Vienna

M Schwarz
1   Wilhelminenspital, 4. Med. Abteilung, Wien, Austria
2   Medizinische Universität Wien, Universitätsklinik für Innere Medizin III, Klinische Abteilung für Gastroenterologie und Hepatologie, Wien, Austria
3   Vienna HIV & Liver Study Group, Wien, Austria
,
S Gremmel
4   neunerhaus Gesundheitszentrum, Wien, Austria
,
M Wurz
4   neunerhaus Gesundheitszentrum, Wien, Austria
,
C Schmidbauer
1   Wilhelminenspital, 4. Med. Abteilung, Wien, Austria
2   Medizinische Universität Wien, Universitätsklinik für Innere Medizin III, Klinische Abteilung für Gastroenterologie und Hepatologie, Wien, Austria
3   Vienna HIV & Liver Study Group, Wien, Austria
,
E Gutic
1   Wilhelminenspital, 4. Med. Abteilung, Wien, Austria
,
T Lang
1   Wilhelminenspital, 4. Med. Abteilung, Wien, Austria
,
T Reiberger
2   Medizinische Universität Wien, Universitätsklinik für Innere Medizin III, Klinische Abteilung für Gastroenterologie und Hepatologie, Wien, Austria
3   Vienna HIV & Liver Study Group, Wien, Austria
,
M Gschwantler
1   Wilhelminenspital, 4. Med. Abteilung, Wien, Austria
5   Sigmund Freud Universität, Wien, Austria
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Background Homeless and/or people without medical insurance are often not considered in epidemiological models for HCV elimination despite their important role for ongoing viral transmission. We conduct an HCV screening and elimination project specifically targeting the homeless and/or non-insured HCV population.

Methods “neunerhaus” is a social organization in Vienna providing integrative care for homeless people and people without medical insurance. It provides a range of medical services as well as non-medical support through social workers, and is associated with apartment buildings for temporary housing. Mobile teams of physicians regularly visit 27 different housing institutions for homeless in Vienna offering medical services to temporary and permanent residents. 5.000 patients are seen at the “neunerhaus” institutions every year, making the organization an important screening platform for HCV patients.Starting in March 2020, all individuals visiting one of the “neunerhaus” institutions are included in this study. Socioeconomic parameters and medical conditions are recorded using a questionnaire. All patients undergo HCV-serology testing followed by HCV-RNA PCR in anti-HCV(+) patients. Patients with HCV-RNA viremia receive DAA therapy and are provided with housing for the duration of therapy. In patients with suspected high risk of non-adherence to therapy, DAA are administered according to the concept of directly observed therapy. Treatment for patients without medical insurance is generously provided by Abbvie® and Gilead®.

Results Preliminary results will be presented at the conference.

Conclusion Here we present a promising HCV screening and treatment approach targeting homeless people and patients without medical insurance. This specific concept of screening and treatment may help to eliminate HCV in this previously underreported group of patients.

Medication for uninsured patients will be kindly by Abbvie® and Gilead®.



Publication History

Article published online:
26 May 2020

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