Linkage to Care Rates among Individuals Testing Positive for Chronic Hepatitis C Infection at Substance Use Treatment Centers

Friday, June 19th 2020

1:00 PM - 2:30 PM


Injection drug use accounts for more than 50% of existing cases and more than 70% of incident cases of Hepatitis C virus (HCV) infections in the United States. We have implemented HCV testing and linkage to care services at inpatient and outpatient substance use disorder programs. We aim to determine if individuals tested in these programs successfully engage in HCV care. Participants include all chronically HCV infected adults who were diagnosed via community-based point-of-care HCV antibody testing with reflexive blood draw for confirmatory PCR testing. Testing was offered at 13 substance use disorder treatment programs between 1/1/2018 – 12/31/2018, the one year time frame following the removal of Medicaid disease severity prior authorization criteria in Pennsylvania. We reviewed medical charts to determine clinic attendance at initial and follow up visits and treatment initiation. During the study period 1007 individuals were tested and 326 individuals were diagnosed with chronic HCV infection. Our results demonstrate that 53% of individuals who tested positive for chronic HCV in substance use disorder treatment programs were successfully linked to a first HCV evaluation, with a mean of 48 days between confirmatory test and evaluation appointment. 80% of patients who attended a second visit initiated treatment, with a mean of 103 days between confirmatory test and treatment initiation. Decreasing the time between HCV diagnosis and linkage to HCV care will likely lead to improved rates of evaluation and HCV treatment in patients identified in substance use disorder treatment programs. New strategies must be developed, evaluated, and implemented in order to achieve this goal.


Alexandra Ripkin

Alexandra Ripkin has been with Philadelphia FIGHT since 2016. She currently works as Project Coordinator with C a Difference, FIGHT’s comprehensive hepatitis C (HCV) testing and linkage-to-care program. She coordinates HCV treatment for FIGHT patients across clinical settings, manages data for daily operations and research dissemination, and collaborates on harm reduction projects throughout FIGHT programs. Alexandra has also previously assisted with the establishment of the satellite primary care clinic at Broad Street Ministry and served as Program Manager of Clínica Bienestar, the HIV primary care clinic within Prevention Point Philadelphia. Alexandra graduated from Temple University with duel Master’s degrees in Public Health and Social Work.

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Spotlight On

Karam Mounzer, MD

Dr. Mounzer identified two major gaps in the care of patients with HIV/hepatitis C (HCV) co-infection, and the complexity of multidrug-resistant HIV treatment. He is involved with many clinical trials focusing on drug development and better understanding of HIV immunopathogenesis with the Wistar Institute. He is involved in teaching and mentoring.

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Dr. Karam Mounzer

Dr. Mario Cruz

Dr. Mario CruzDr. Cruz is a board certified pediatrician who serves as the Medical Director for our Pediatrics and Adolescent Health Center. He has presented and/or published in the fields of community violence and domestic violence prevention, quality improvement, behavioral health, curriculum development and mentorship. In 2019 he received the Greater Philadelphia Social Innovation Award for Innovations in Healthcare.

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