A future in FOCUS

With rates of Hepatitis C (HCV) infections climbing in the United States, many health professionals would describe this increase as an emerging public health crisis.  Research suggests that the increase in Hepatitis C infections could be linked to the increase of injection drug use throughout the country. Unfortunately, West Virginia is no stranger to the injection drug use epidemic.  In fact, the use of opioids in the Mountain State became a major issue that prompted even President Barak Obama to visit the capital in 2015 to have a community discussion about the wave of drug abuse.

FOCUS (On the Frontlines of Communities in the United States) – a Gilead Sciences, Inc. initiative launched in 2010, was created to address the issue of HIV/AIDS transmissions and to inform those who did not know they were infected or at risk.  Later, in 2013, FOCUS also added Hepatitis C testing per recommendation from the Center for Disease Control and by the United States Preventative Services Task Force.  The main goal? To make HIV and HCV screening a standard of care and to change public perceptions as well as overcome stigma that may have discouraged this type of testing.

West Virginia University’s Department of Emergency Medicine saw a need for implementation of the FOCUS objectives right here in the state of West Virginia–so that’s exactly what they did.  After the Department of Emergency Medicine submitted a grant proposal to Gilead, the proposal was accepted, and testing is now underway in the West Virginia University Hospitals/J.W. Ruby Memorial Hospital Emergency Center, the WVU Comprehensive Opioid Addiction (COAT) Clinic, as well as in WVU Student Health and in WVU Medicine’s two Urgent Care Centers in Morgantown, WV.

Dr. Ian Martin, Chair of the Department of Emergency Medicine, saw the FOCUS initiative as an important project that was directly related to the overarching goals of the Department.

“The FOCUS partnership, in many ways, is our Department’s vision in action—bolstering the standing of the Department while directly benefiting West Virginians.  We leveraged departmental expertise and infrastructure to win this competitive grant, and in doing so, we have already increased our Emergency Center-based HIV and HCV testing by over 5000%.  With this ramped up testing, we have enhanced the care of West Virginians through increased detection of the diseases and linkage to care.  In recognition of this work, we have been invited to discuss our efforts at various national venues,” said Martin.

Stephen Davis, Interim Vice-Chair for Research and Scholarship in the Department of Emergency Medicine, noted the importance of these test results and the difference they can make in the life of a patient living with Hepatitis C or HIV.

“Currently, West Virginia ranks second in the nation in the rate of acute HCV infections.   A substantial proportion of these infections are acquired through injection drug use, which increases concern over possible co-infection with HIV.  In addition to helping prevent disease transmission through early identification, our program also links patients to care, which is now more important than ever given that HCV is largely curable and HIV can be managed as a chronic condition,” said Davis.

Davis also went on to explain that the Department of Emergency Medicine at WVU would be sharing the model they developed for this type of screening process with other clinical sites and settings around the state and region.  

“Ultimately, we believe that scaled-up, electronic medical record (EMR)-based screening and linkage to care will reduce morbidity and mortality associated with HCV and HIV in both West Virginia and other rural states grappling with the current opioid epidemic.”, he said.

Most recently, the FOCUS team at the Department of Emergency Medicine, including Mindy Sharon, Steve Davis, Dr. Carmen Burrell (co-investigator (Co-I)), Dr. Judith Feinberg (Co-I), Julie Nist, Dr. Owen Lander, Valerie Boley, Justin Burns, and Dr. Ian B.K. Martin (principal investigator), was invited to give an oral presentation at the 6th International Conference on Viral Hepatitis in Chicago.  The invitation to present came after the team’s submission of the abstract titled, Killing Two Birds with One Stone: Using the Electronic Medical Record to Scale-up Testing for HIV and Hepatitis C Virus in an Appalachian Setting.

The Department is excited for the findings that this particular contract with Gilead will bring in the future, and about the potential for future research based on the capabilities of the electronic medical record.

For more information about FOCUS and WVU’s Department of Emergency Medicine, or to schedule an interview, please contact Chelsea Betts at 302-249-6732 or at Chelsea.betts@wvumedicine.org.