The BBV Champions Model an innovative tool for HCV testing in hard to reach communities
by Royal Berkshire Hospital
Built on a concept developed in rural Africa, the BBV Champions is a model to address the shortfall in detection on Hepatitis C in the UK – using local available resources to raise awareness, offer testing, provide provisional results and support service users on the treatment pathway. It has had a significant impact in Reading, Berkshire, in increasing uptake of testing in two high prevalence communities: substance misusers and the local Pakistani population. BBV Champions provides an effective structure to identify significantly more people infected by HCV and to guide them into treatment services which will have an impact on future infection rates and a reduction in advanced liver disease associated with late diagnosis and limited monitoring.
"The judges recognised the excellent investment Royal Berkshire Hospital placed in education, providing information in all relevant languages. This was a different and unique tool for HCV testing, taking what had been learnt in the 3rd world to this country."
‘Going Viral’: Hepatitis C/B/HIV testing in 9 emergency departments
by Barts Health NHS Trust
The week-long campaign offered HIV/HBV/HCV routine testing in nine UK emergency departments and investigated the uptake and yield of a combined BBV opt-out testing strategy – the first in the UK. A partnership between the NHS, pharma (Gilead and AbbVie) and patient groups such as the Hepatitis C Trust, the campaign was endorsed by several medical societies.
Public engagement in the BBV concept was key, and celebrity patrons helped achieve high-profile media coverage. Of 7,800 patients who had bloods taken over that week across the 9 EDs, 2,118 people were tested for BBVs (uptake was 27%). The prevalence of BBVs in the tested group was over 3% and 71 infections were found, many of which would have been missed by testing for HIV alone.
"Barts Health NHS Trust has produced a brilliant initiative for raising awareness. They successfully engaged ED, which in itself is fantastic."
Fibroscanning HCV with bespoke outreach clinics achieves high patient engagement
by Imperial College Healthcare NHS Trust
The Trust developed a bespoke outreach fibroscan and testing service for the assessment of Hepatitis C and liver disease. It is a quick, painless and non-invasive examination used to assess liver stiffness, taking between 10 to 15 minutes.
The results are immediate, allowing assessment of underlying stiffness, counselling, health education and the ongoing monitoring of improvement or progression of disease. The Liver Treatment Unit at Imperial College Healthcare NHS Trust at St Mary’s Hospital has substantial resources and an expert team which manages and cares for all forms of liver disease - and currently performs one of the largest nurse-led assessment clinics in London, reducing the need for liver biopsies. The aim is to utilise the skills and experience gained in order to expand the service to more diverse settings.
"This entry worked well as it gave the local community the opportunity to turn up for a Fibroscan. It is a great resource and is popular as a non-invasive test."
Hepatitis B and Hepatitis C virus case finding in prisons
by Maidstone and Tunbridge Wells NHS Trust
The project aimed to assess the feasibility of blood spot testing for HBV and HCV in a category B and C prison and to evaluate the number of prisoners seen and treated in the liver clinic. A walk-in service was provided in Elmley Prison to test for hepatitis B and C, followed by clinic appointments at Maidstone Hospital in all positive cases: 160 prisoners were tested for HCV antibodies of which 33.75% were positive, and those that were positive for Hepatitis C virus then went on to be tested for HCV RNA where 23.75% were RNA positive. The results highlight that HCV testing in prisons has the potential to vastly increase the number of people who are identified as HCV positive.
"There is a requirement for all prisoner to be tested by the Government, but this is not happening. Maidstone and Tunbridge Wells NHS Trust have ensured that it takes place in their prisons and have ensured that care is given in this tough environment."