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Abstract Details
The impact of point-of-care hepatitis C testing in needle and syringe exchange programs on linkage to care and treatment uptake among people who inject drugs: An Australian pilot study
J Viral Hepat. 2022 Mar 11. doi: 10.1111/jvh.13664. Online ahead of print.
Jessica Howell1234, Michael W Traeger12, Bridget Williams1, Chloe Layton5, Joseph S Doyle16, Ned Latham17, Bridget Draper12, Frances Bramwell5, Dean Membrey5, Maggie Mcpherson8, Janine Roney9, Mark Stoové1, Alexander J Thompson34, Margaret E Hellard12610, Alisa Pedrana12
Author information
Disease Elimination Program, Burnet Institute, Melbourne, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
Department of Medicine, University of Melbourne, Melbourne, Australia.
Cohealth, General Practice, Melbourne, Australia.
Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Australia.
Department of Infectious Diseases, Monash University, Melbourne, Australia.
North Richmond Community Health, General Practice, Melbourne, Australia.
Department of Infectious Diseases, The Alfred, Melbourne, Australia.
Doherty Institute and School of Population and Global Health, University of Melbourne.
Abstract
Point-of-care (POC) diagnostics overcome barriers to conventional hepatitis C (HCV) testing in people who inject drugs. This study assessed impact on hepatitis C treatment uptake of POC HCV testing in needle and syringe exchange programs (NSPs). Rapid EC was a single arm interventional pilot study of HCV POC testing conducted in three inner-city community clinics with NSPs. Twelve months after the POC testing, a retrospective medical record and Pharmaceutical Benefits Scheme audit was performed to determine the number of HCV RNA positive participants who were prescribed HCV treatment. 70 HCV RNA positive Rapid EC study participants were included. 44 (63%) were prescribed DAAs; 26 (59%) completed treatment and 15 (34%) had SVR testing, all of whom were cured. Age ≥40 years (aOR 3.45, 95% CI 1.10-11.05, p=0.03) and secondary school education (aOR 5.8, 95% CI 1.54-21.80, p=0.009) had higher likelihood of being prescribed DAAs, whereas homelessness was inversely associated with prescription of DAAs (aOR 0.30, 95% CI 0.09-1.04, p=0.057). Median time to receive a DAA script from date of diagnosis was seven days (IQR 0 to 14 days) and time to filling the DAA prescription was 2 days (IQR 0-12 days). In conclusion, provision of POC testing through NSPs was effective for linking new clients to HCV treatment and reduced the time to treatment. Further studies are needed to define the most cost-effective use of POC testing in models of care for people who inject drugs to increase HCV treatment uptake.