Dr Margaret Bourke is General Practitioner in Dublin Ireland. She has worked in HSE addiction services since 1994, developing services and treating Patients. Since 2017 Dr Bourke has worked under auspices of the Hepatitis C treatment programme. treating viral hepatitis in Opioid Substitution treatment settings.

Background
Ireland had one of the longest Covid lockdown in Europe with two major lockdowns and with varying levels of restrictions till March 2022
We continued to provide face to face treatment for our patients
Previously we treated 197 patients for Hepatitis C (HCV) in our Opiate Substitution treatment services (OST) in this cohort we obtained a Sustained Virological response of 99% with a view to micro-elimination.

Treatment was provided by an addiction General Practitioner, Nurse Specialist and Pharmacist

COVID pandemic
During the first year of the Pandemic 643 persons applied to enter OST treatment.
50% were homeless, living on the street /temporary transient accommodation
Testing and treating all new entrants for HCV was prioritised to maintain micro-elimination.
Treatment
40 were HCV PCR positive
35 Patients treated with Direct acting antiviral (DDA) for 8 weeks regardless of continued drug or alcohol use
Treatment dispensed at OST clinics
Psychosocial supports provided.
During travel restrictions medication was delivered by the outreach team if necessary.
Results
35 completed treatment SVR 100%
4 patients referred to Hepatology with advanced cirrhosis
1 patient disengaged


Beneficiaries of temporary protection and those seeking international protection

The war in Ukraine saw an influx of Ukrainians into Ireland 47,692
Over the same period the number of Georgians entering Ireland increased to 1,792
Transient accommodation and language barriers have proved challenging
Results
20 patients have presented to our OST services
Virological screening:
11 HCV RNA positive
4 co-infected referred to Infectious-disease services
3 HCV RNA positive
1 completing treatment
1 retreat - due to commence treatment
1 completing work up
2 defaulted from OST

Treating HCV in OST services in transient populations has proved possible and successful.
SVR rate of 100% was achieved in COVID cohort