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Abstract Details
Impact of COVID-19 lockdown restrictions on hepatitis C testing in Australian primary care services providing care for people who inject drugs
1Burnet Institute, Melbourne, Victoria, Australia.
2School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
3Department of Infectious Disease, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, the Netherlands.
4Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
5Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
6Australian Human Rights Institute, UNSW Sydney, Sydney, New South Wales, Australia.
7Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia.
8Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
9Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
10Access Health, Melbourne, Victoria, Australia.
11Hepatitis Australia, Canberra, Australian Capital Territory, Australia.
12Sydney Sexual Health Centre, Sydney, New South Wales, Australia.
13Peter Doherty Institute, Melbourne, Victoria, Australia.
Abstract
In 2020, the Australian state of Victoria experienced the longest COVID-19 lockdowns of any jurisdiction, with two lockdowns starting in March and July, respectively. Lockdowns may impact progress towards eliminating hepatitis C through reductions in hepatitis C testing. To examine the impact of lockdowns on hepatitis C testing in Victoria, de-identified data were extracted from a network of 11 services that specialize in the care of people who inject drugs (PWID). Interrupted time-series analyses estimated weekly changes in hepatitis C antibody and RNA testing from 1 January 2019 to 14 May 2021 and described temporal changes in testing associated with lockdowns. Interruptions were defined at the weeks corresponding to the start of the first lockdown (week 14) and the start (week 80) and end (week 95) of the second lockdown. Pre-COVID, an average of 80.6 antibody and 25.7 RNA tests were performed each week. Following the first lockdown in Victoria, there was an immediate drop of 23.2 antibody tests and 8.6 RNA tests per week (equivalent to a 31% and 46% drop, respectively). Following the second lockdown, there was an immediate drop of 17.2 antibody tests and 4.6 RNA tests per week (equivalent to a 26% and 33% drop, respectively). With testing and case finding identified as a key challenge to Australia achieving hepatitis C elimination targets, the cumulative number of testing opportunities missed during lockdowns may prolong efforts to find, diagnose and engage or reengage in care of the remaining population of PWID living with hepatitis C.