ABSTRACT

Objectives. A key strategy in the national Viral Hepatitis Plan is to strengthen partnerships
connecting local health departments, community-based organizations and healthcare providers
for hepatitis services. We implemented a hepatitis C virus (HCV) testing and linkage to care
program at a local public health level, using similar strategies reported for HIV care.
Methods. HCV antibody testing with reflex RNA was coordinated through the Durham County
Department of Public Health in Durham, North Carolina. Testing was offered at the: 1) STD
clinic; 2) county jail; 3) community testing sites, including a residential substance abuse recovery
program; and 4) a homeless clinic. Persons with chronic HCV infections were linked to care
through an HCV bridge counselor or patient navigator who provided HCV education,
incentives, transportation, and scheduled appointments with HCV specialists at nearby academic
centers and on-site clinics.
Results. From December 2012 - February 2014, we conducted 2004 HCV tests, of which 326
(16.3%) were HCV antibody positive and 241 (12.0%) had detectable HCV RNA. Among
persons with chronic HCV infections, 73.9% were men and 55.2% were born from 1945 through
1965. The proportion of persons with chronic HCV infections who reported ever injecting drugs
was 62.2%; only 2.5% had HIV co-infection. We linked 51% of chronically infected persons to
HCV care during the project period.
Conclusions. At the local public health level, HCV testing and linkage to care can be facilitated
with the support of federal funds, and by leveraging existing programs and provider networks to
deliver a coordinated system of care.