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HCV point-of-care diagnostics remove barriers to care

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Findings presented at the International Liver Congress suggest that point-of-care testing for hepatitis C virus infection in community clinics in Australia was acceptable to patients and feasible, specifically for people who inject drugs, or PWID.

Bridget Williams, MD, public health registrar for the Burnet Institute in Melbourne, Australia, and colleagues identified 174 individuals who were at high risk for HCV from three clinics with needle and syringe exchange programs (NSP) in the Melbourne metro area. Overall, the mean age of participants was 41 years, 67% were male, 88% had injected drugs within the past 6 months and 53% had shared injecting equipment within the past 6 months.

Study participants first underwent an OraQuick HCV antibody mouth swab test (OraSure Technologies, Inc.), which took 20 minutes to produce results. If results were positive, participants were offered venipuncture for the Xpert HCV Viral Load assay (Cepheid) to detect HCV RNA, which took 105 minutes for results. According to the presentation, same-day results were delivered on site, via phone or text message or upon the patient’s return to the clinic. Additionally, participants completed demographic, behavioral and acceptability surveys and were invited for follow-ups.

Of the 174 participants, 86% had a positive result after the initial point-of-care testing for HCV antibodies. The researchers said 140 participants (93%) underwent a point-of-care HCV RNA test, and 54% had detectable RNA. Although 61% chose to receive their point-of-care RNA results via phone or text message, 5% opted to wait onsite for their results. Furthermore, a 4-week period since point-of-care testing and HCV diagnosis had elapsed for 67 individuals, of whom 60% had returned for follow-up. Williams and colleagues said 85% of participants preferred the point-of-care tests over standard HCV testing processes.

Williams said the turnaround times for test results were too slow for PWID to receive same-day, on-site results but “despite this, we did have good rates of follow-up, which shows this model can successfully link people who inject drugs into hepatitis C care,” she told Infectious Disease News.

Researchers concluded that point-of-care testing for HCV is not only effective in increasing HCV care, but it is also feasible and acceptable for PWID when provided through NSP services in community clinics.

“Many participants had received their diagnosis of hepatitis C many years ago but had not sought out care, despite the new, very effective treatments being available in Australia,” Williams said. “This suggests that the use of point-of-care tests could serve to re-engage patients into care.” – by Marley Ghizzone

Reference:

Williams B, et al. Abstract 405. Presented at: International Liver Congress; April 11-15, 2018; Paris.

Disclosure: Williams reports no relevant financial disclosures. Please see the study for all other authors relevant financial disclosures.