Hepatitis C Free Baleares

Duration

2021-2023

Coordinator

Jeffrey Lazarus (ISGlobal)

Funded by

Gilead Sciences HCV-STAT Programme

The objective of this study is to eliminate hepatitis C virus (HCV) in the autonomous community of the Balearic Islands using the micro-elimination approach. The project aims to reach patients with a history of drug use who are treated in the different governmental and non-governmental addiction service centres, a mobile methadone unit, or are in prison, in order to test and link people who use drugs to HCV care.

Photo (Creu Roja Illes Balears): The project coordinator (Andrea Herranz) carrying out the recruitment and screening of a mobile methadone bus (Metabús) participant.

The purpose of this project is to diagnose and treat hepatitis C in this key population group with a new model of care that simplifies the current diagnosis process and facilitates linkage to care and subsequent treatment initiation.

In the different addiction services centres (Unitats de Conductes Addictives; UCAs), patients will be screened for HCV using a saliva-based rapid detection test (Oraquick®, Orasure Technologies Inc.,) to detect the presence of HCV antibodies (HCV Ab) followed by a dried blood spot (DBS) sample to confirm viremia (HCV-RNA). Treatment will be prescribed by a hepatologists to those patients who are positive for the infection via telemedicine and will be delivered and administered at the same addiction services centres. To confirm the completion of treatment and sustained virologic response (SVR), in addition to possible reinfections, monitoring utilizing DBS will be carried out for up to a year after treatment completion.

The project commenced its testing activities in April 2021 and has been implemented in 21 study sites, 16 are in place in the Island of Mallorca, two in Ibiza and three in Menorca. As of April 2023, 1,423 people have been tested, of which 12% (n=170) had an active hepatitis C infection (HCV-RNA+). Of those, 86% (n=147) have started treatment and 84% (n=124) of them have already finished it. SVR12 monitoring was performed 12 weeks after treatment in 77% of those who finished treatment, and the 93% of cases got an undetectable result, meaning they were cured of hepatitis C. 

Photo: Andrea Herranz. Poster of the project in two of the addiction services centres (UCA and Projecte Home).

Photo: Andrea Herranz. Health staff from Projecte Home (non-governmental addiction service centres) explaining the project to a participant.

This project is led by the ISGlobal Health Systems Research group in collaboration with Hospital Universitari Son Llàtzer (Mallorca), Hospital Universitari Son Espases (Mallorca), Hospital Comarcal d’Inca (Mallorca), Hospital Comarcal de Manacor (Mallorca), Hospital General Mateu Orfila (Menorca), Hospital Can Misses (Eivissa), Hospital Vall d’Hebron (Barcelona) and is funded through the competitive research call HCV STAT, by Gilead Sciences. 

Abstracts

• Lazarus JV, Vilella À, Picchio CA, Herranz A, Buti M. Eliminating hepatitis C on the Balearic Islands by linking patients who use drugs from addiction service centers, a local NGO, a prison and a mobile methadone bus to HCV care. (Poster presentation). HepHIV Conference, 2021.  
• Herranz A, Vilella À, Agius A, Alonso JM, Rodríguez A, Picchio CA, Guy D, Pujol C, Buti M, Lazarus JV. The impact of the COVID-19 pandemic on harm reduction services in a prison and addiction centres in the Balearic Islands, Spain: preliminary results from a novel hepatitis C elimination programme. HepHIV Conference, 2021.  
• Lazarus JV, Herranz A, Picchio CA, Villota-Rivas M, Perrotta A, Tegeo E, Buti M, Vilella À. New model of care for hepatitis C launched after 1 year of the COVID-19 pandemic in the Balearic Islands: first results. (Poster presentation). INHSU 2021 conference.
• Herranz A, Pujol C, Vilella À, Picchio CA, Agius A, Alonso JM, Rodríguez A, Perrotta A, García L, Mercadal B, Serrano J, Fernández F, Anoz L, Doran J, Buti M, Lazarus JV. The impact of the COVID-19 pandemic on harm reduction services in addiction centres and on the DAA treatment initiated in the Balearic Islands, Spain: Preliminary results from a novel hepatitis C elimination programme. (Poster presentation). INHSU 2021 conference.
• Perrotta A, Tegeo Molina E, Herranz Mochales A, Vilella Martorell À, Buti Ferret M, Lazarus JV. Eliminando la hepatitis C en las Islas Baleares: intervención en Projecte Home Balears. (Oral presentation). Socidrogalcohol 2021.
• Herranz A, Vilella À, Perrotta A, Tegeo E, Agius A, Izquierdo J, Pol M, Martorell M, Serra J, Vidal M, Martínez G, Alonso JM, Torres A, De Cien N, Oliver A, Rosselló M, Buti M. Eliminating hepatitis C in the Balearic Islands, Spain: a study in governmental and non-governmental addiction service centres to test and link people who use drugs to HCV care. (Poster presentation). IVHEM 2021.
• Herranz A, Fernández-Baca MV, Serrano J, Bonet L, Macià MD, Ventayol P, Trelles M, Fernández F, Martín L, R Rubí A, Hurtado A, Anoz L, Sansó A, Maesrte MA, Morego A, Buti M, Vilella À, Lazarus JV. HCV micro-elimination strategies for the PWUD population of the Balearic Islands. (Poster presentation). EASL Hepatitis monothematic 2022.
• Herranz Mochales A, Fernández-Baca MV, Macià MD, Díaz MP, Gallegos MC, Arcay RM, Salvà F, Hurtado A, Buti M, Vilella À, Lazarus JV. SVR4 and SVR12 monitoring by using dried blood spot (DBS) test: is it the best alternative for PWUD? (Poster presentation). The International Liver Congress (ILC) 2022.
• Herranz A, Trelles M, Bonet L, R Rubí A, Martín L, Sansó A, Gelabert, J, Buti M, Vilella À, Lazarus JV. Nuevo modelo de atención para la micro eliminación de la hepatitis C en PWUD de las Islas Baleares. (Poster presentation). 47º congreso AEEH 2022.
• Herranz A, Vidal M, Pol M, Martorell M, Alonso JM, Morey A, Agius A, Ramos B, De Cien N, Oliver A, Rosselló M, Lloves M, Soria N, Serra J, Velasco S, García E, Estapé R, Cuaresma I, Moreno V, Picchio CA, Buti M, Vilella À, Lazarus JV. A new model of care for HCV elimination in PWUD in the Balearic Islands, Spain. (Poster presentation). INSHU 2022.
• Herranz A, García M, Murillas J, Bonet L, Martorell F, Cantarero R, Trelles M, Canet R, Fernández P, R Rubí A, Martín L, Vilaplana L, Sansó A, Gelabert J, Escudero M, Buti M, Vilella À, Lazarus JV. Hepatitis C Free Balears: a micro-elimination program focused on people who use drugs in the Balearic Islands, Spain. (Poster presentation). IVHEM 2022.
• Herranz A, Serrano J, Ventayol P, Fernández F, García M, Martorell F, Perrotta A, Tegeo E, Buti M, Vilella À, Lazarus JV. Diagnóstico y tratamiento de la hepatitis C en las personas que usan drogas en las Islas Baleares, España. (Poster presentation). AEEH 2023.
• Herranz A, Picchio CA, Bonet L, Trelles M, R Rubí A, Martín L, Sansó A, Moreno V, Sánchez A, Serra J, Velasco MS, Joy R, Lloves M, Soria N, Buti M, Vilella À, Lazarus JV. Hepatitis C virus infection follow-up of people who use drugs in the Balearic Islands, Spain. (Poster presentation). EASL 2023.
• Herranz Mochales A, Fernández-Baca MV, Díaz MP, Macià MD, Pol M, Cuaresma I, De Cien N, Gallegos MC, Salvà F, Hurtado A, Buti M, Vilella À, Lazarus JV. Use of dried blood spot test for HCV screening and diagnosis among people who use drugs in the Balearic Islands, Spain. (Poster presentation). GHS-Paris 2023.
• Iglesias C, Fernández-Billón M, Herranz A, Candia V, Pérez M, Arcay R, Lazarus JV, Fraile P, Oliver A, Macià MD. Implementación del cribado diagnóstico de la hepatitis C (VHC) en sangre seca (dried blood spot [DBS]) de poblaciones de alto riesgo en Baleares. (Oral presentation). SEIMC 2023.    
• Herranz A, Bonet L, Trelles M, R Rubí A, Martín L, Sansó A, Gelabert J, García Gasalla M, Buti M, Vilella À, Lazarus JV. The Hepatitis C Free Balears project: an hepatitis C model of care adapted to PWUD from the Balearic Islands, Spain. (Oral presentation). INHSU 2023

Papers

• Lazarus JV, Herranz A, Picchio CA, Villota-Rivas M, Rodríguez A, Alonso JM, Moratinos A, Perrotta A, Tegeo E, Bibiloni F, Buti M, Vilella À. Eliminating hepatitis C on the Balearic Islands, Spain: a protocol for an intervention study to test and link people who use drugs to treatment and care. BMJ Open. 2021 Oct 21;11(10):e053394. doi: 10.1136/bmjopen-2021-053394. PMID: 34675021; PMCID: PMC8532552. pubmed.ncbi.nlm.nih.gov/34675021.