Author information
1Infectious Diseases Department, Royal Adelaide Hospital, South Australia, Australia.
2Disease Elimination, Burnet Institute, Victoria, Australia.
3Gastroenterolgy & Hepatology Department, Royal Adelaide Hospital, South Australia, Australia.
4Hepatology and Liver Transplantation Medicine Unit, Southern Adelaide Local Health Network, South Australia, Australia.
5Drug and Alcohol Services, South Australia, Australia.
6Communicable Disease Control Branch, SA Health, South Australia, Australia.
Abstract
Background: A barrier to hepatitis C virus (HCV) cure is conventional testing. The aim of this study was to evaluate the effect of HCV antibody and RNA point-of-care-testing (POCT) on testing rates, linkage to care, treatment and acceptability of testing in three priority settings in Australia.
Methods: Participants were enrolled in an interventional cohort study at a reception prison, inpatient mental health service (MHS), and inpatient alcohol and other drug (AOD) unit-between October 2020 and December 2021. HCV POCT was performed using SD Bioline HCV antibody fingerstick test and a reflexive Xpert® HCV Viral Load Fingerstick test using capillary blood samples. A retrospective audit of HCV testing and treatment data was performed at each site for the preceding 12-month period to generate a historical control.
Results: 1,549 participants received a HCV antibody test with 17% (264/1,549) receiving a positive result, of which 21% (55/264) tested HCV RNA positive. Across all settings the rate of testing per year significantly increased between the historical controls and the study intervention period by three-fold (RR:2.57 95% CI: 2.32, 2.85) for HCV antibody testing and four-fold (RR:1.62; 95% CI:1.31, 2.01) for RNA testing. Treatment uptake was higher during the POCT intervention (86%, 47/55; P=0.010) compared to the historical controls (61%, 27/44).
Conclusions: This study demonstrated across three settings that the use of HCV antibody and RNA POCT increased testing rates, treatment uptake linkage to care. The testing model was highly acceptable for most participants.
Clinical trial registration: ACTRN-12621001578897.