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M.C. Thurnheer 1,2 , S. Wildbolz 1 , U.Breckner 3 , H. Furrer 1

Improving medical care for people who inject drugs in Switzerland: results from an integrated approach to HIV and HCV management. M.C. Thurnheer 1,2 , S. Wildbolz 1 , U.Breckner 3 , H. Furrer 1. Koda Bern: On-site heroin maintenance treatment for PWID

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M.C. Thurnheer 1,2 , S. Wildbolz 1 , U.Breckner 3 , H. Furrer 1

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  1. Improving medical care for people who inject drugs in Switzerland: results from an integrated approach to HIV and HCV management M.C. Thurnheer1,2, S. Wildbolz1, U.Breckner3, H. Furrer1 • Koda Bern: • On-site heroin maintenance treatment for PWID • Access to psychiatric and nursing care and social work • On-site medical care since 2009 Methods: Two cross-sectionals surveys performed in 2009 and 2012 to assess medical comorbidities, medical work-up and treatment uptake with a special focus on HIV and HCV care. Patients 2012: 216 Patients, 153 male, median age 43 years (min 23 years, max 75 years), on treatment for 8.5 years (median)

  2. HIV HIV prevalence:10% In 2009 15/24 patients were on ART. Of the 9 untreated patients 7 would have qualified for ART according to guidelines In 2012 22/22 patients received ART.

  3. HCV 96 patient suffered from chronic HCV Assessment for chronic HCV infection was improved from 123/160 Abpos patients in 2009 to 155/163 patients in 2012

  4. HCV: “Just treat them”…? 216 patients 209/216 screened 7/216 not screened 209/216 screened 163/209 HCV Abpos 46/209 HCV Abneg 163/209 HCV Abpos • Reasons for not evaluating: • patient declined (15) • comorbidities (6) • patient not stable (7) • not urgent (1) • evaluation planned (13) • reason not stated (2) 96/163 chronic HCV 59/163 cleared HCV 8/163 HCV RNA nd 96/163 chronic HCV 44/96 not evaluated for HCV treatment 50/96 evaluated for HCV treatment 50/96 evaluated for HCV treatment 2/96 no information 44/96 not evaluated for HCV treatment • Reasons for not treating: • patient declined (10) • patient not stable (3) • not urgent (9) • waiting for better options (3) 16/50 treated 9/50 treatment planned 25/50 no treatment planned 16/50 treated 25/50 no treatment planned

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