Point-of-care hepatitis C testing from needle and syringe programs

An Australian feasibility study

Bridget Williams, Jessica Howell, Joseph Doyle, Alexander J. Thompson, Bridget Draper, Chloe Layton, Ned Latham, Frances Bramwell, Dean Membrey, Maggie Mcpherson, Janine Roney, Mark Stoové, Margaret E. Hellard, Alisa Pedrana

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background: Achieving hepatitis C elimination requires novel approaches to engage people at highest risk of infection into care pathways. Point-of-care-tests may help to overcome some of the barriers preventing people who inject drugs (PWID) accessing testing and progressing to treatment for hepatitis C virus (HCV). We assessed the feasibility and acceptability of HCV point-of-care testing at needle and syringe exchange programs (NSPs) co-located in three community health clinics in Melbourne, Australia. Methods: NSP clients were offered an oral fluid point-of-care test for HCV antibody by NSP staff. Positive HCV antibody tests were followed by a point-of-care test for HCV RNA alongside standard-of-care laboratory testing for hepatitis C treatment work-up. Participants were offered same-day point-of-care results on site, via phone or text message, or upon return to the service. Participants were scheduled for follow-up review with the study nurse for assessment and linkage to treatment. Results: A total of 174 participants completed HCV antibody point-of-care test; 150 (86%) had a reactive result. Of these, 140 (93%) underwent a HCV RNA point-of-care test and 76 (54%) tested positive; few participants (5%) waited on site for results delivery, but the majority of RNA positive (63%) attended a follow-up visit for treatment work-up (median time to follow-up visit = 11 days; IQR = 7–20 days). The majority of participants reported a preference for point-of-care tests (66%) and supported NSP staff involvement in testing (90%). Conclusion: Provision of HCV point-of-care tests, follow-up and linkage to treatment services through NSPs was feasible and acceptable to PWID. Despite few participants waiting to receive same-day results, there was effective linkage to care, suggesting value in further evaluation of this approach.

Original languageEnglish
Number of pages8
JournalInternational Journal of Drug Policy
DOIs
Publication statusAccepted/In press - 22 May 2019

Keywords

  • Harm reduction
  • Health services accessibility
  • Hepatitis C
  • Point-of-care testing

Cite this

Williams, Bridget ; Howell, Jessica ; Doyle, Joseph ; Thompson, Alexander J. ; Draper, Bridget ; Layton, Chloe ; Latham, Ned ; Bramwell, Frances ; Membrey, Dean ; Mcpherson, Maggie ; Roney, Janine ; Stoové, Mark ; Hellard, Margaret E. ; Pedrana, Alisa. / Point-of-care hepatitis C testing from needle and syringe programs : An Australian feasibility study. In: International Journal of Drug Policy. 2019.
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title = "Point-of-care hepatitis C testing from needle and syringe programs: An Australian feasibility study",
abstract = "Background: Achieving hepatitis C elimination requires novel approaches to engage people at highest risk of infection into care pathways. Point-of-care-tests may help to overcome some of the barriers preventing people who inject drugs (PWID) accessing testing and progressing to treatment for hepatitis C virus (HCV). We assessed the feasibility and acceptability of HCV point-of-care testing at needle and syringe exchange programs (NSPs) co-located in three community health clinics in Melbourne, Australia. Methods: NSP clients were offered an oral fluid point-of-care test for HCV antibody by NSP staff. Positive HCV antibody tests were followed by a point-of-care test for HCV RNA alongside standard-of-care laboratory testing for hepatitis C treatment work-up. Participants were offered same-day point-of-care results on site, via phone or text message, or upon return to the service. Participants were scheduled for follow-up review with the study nurse for assessment and linkage to treatment. Results: A total of 174 participants completed HCV antibody point-of-care test; 150 (86{\%}) had a reactive result. Of these, 140 (93{\%}) underwent a HCV RNA point-of-care test and 76 (54{\%}) tested positive; few participants (5{\%}) waited on site for results delivery, but the majority of RNA positive (63{\%}) attended a follow-up visit for treatment work-up (median time to follow-up visit = 11 days; IQR = 7–20 days). The majority of participants reported a preference for point-of-care tests (66{\%}) and supported NSP staff involvement in testing (90{\%}). Conclusion: Provision of HCV point-of-care tests, follow-up and linkage to treatment services through NSPs was feasible and acceptable to PWID. Despite few participants waiting to receive same-day results, there was effective linkage to care, suggesting value in further evaluation of this approach.",
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author = "Bridget Williams and Jessica Howell and Joseph Doyle and Thompson, {Alexander J.} and Bridget Draper and Chloe Layton and Ned Latham and Frances Bramwell and Dean Membrey and Maggie Mcpherson and Janine Roney and Mark Stoov{\'e} and Hellard, {Margaret E.} and Alisa Pedrana",
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Point-of-care hepatitis C testing from needle and syringe programs : An Australian feasibility study. / Williams, Bridget; Howell, Jessica; Doyle, Joseph; Thompson, Alexander J.; Draper, Bridget; Layton, Chloe; Latham, Ned; Bramwell, Frances; Membrey, Dean; Mcpherson, Maggie; Roney, Janine; Stoové, Mark; Hellard, Margaret E.; Pedrana, Alisa.

In: International Journal of Drug Policy, 22.05.2019.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Doyle, Joseph

AU - Thompson, Alexander J.

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AU - Layton, Chloe

AU - Latham, Ned

AU - Bramwell, Frances

AU - Membrey, Dean

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AB - Background: Achieving hepatitis C elimination requires novel approaches to engage people at highest risk of infection into care pathways. Point-of-care-tests may help to overcome some of the barriers preventing people who inject drugs (PWID) accessing testing and progressing to treatment for hepatitis C virus (HCV). We assessed the feasibility and acceptability of HCV point-of-care testing at needle and syringe exchange programs (NSPs) co-located in three community health clinics in Melbourne, Australia. Methods: NSP clients were offered an oral fluid point-of-care test for HCV antibody by NSP staff. Positive HCV antibody tests were followed by a point-of-care test for HCV RNA alongside standard-of-care laboratory testing for hepatitis C treatment work-up. Participants were offered same-day point-of-care results on site, via phone or text message, or upon return to the service. Participants were scheduled for follow-up review with the study nurse for assessment and linkage to treatment. Results: A total of 174 participants completed HCV antibody point-of-care test; 150 (86%) had a reactive result. Of these, 140 (93%) underwent a HCV RNA point-of-care test and 76 (54%) tested positive; few participants (5%) waited on site for results delivery, but the majority of RNA positive (63%) attended a follow-up visit for treatment work-up (median time to follow-up visit = 11 days; IQR = 7–20 days). The majority of participants reported a preference for point-of-care tests (66%) and supported NSP staff involvement in testing (90%). Conclusion: Provision of HCV point-of-care tests, follow-up and linkage to treatment services through NSPs was feasible and acceptable to PWID. Despite few participants waiting to receive same-day results, there was effective linkage to care, suggesting value in further evaluation of this approach.

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KW - Health services accessibility

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