Point-of-Care Antibody Testing for Hepatitis C

Introduction 

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This is a guide to point-of-care antibody testing for hepatitis C virus (HCV) infection. This guide provides an overview of how HCV antibody testing works, and how you can implement it in your service setting. We’ll give you some practical tools, tips, and resources and provide insights into the barriers you may face and how you might be able to overcome these barriers.

The implementation or scaling up of point-of-care HCV antibody testing is specific to each country and/or region and the information we have provided is of a general nature.

The authors and reviewers of this guide include people with lived and living experience of HCV and/or drug use, healthcare practitioners, researchers, laboratory scientists, policy makers and other service providers globally. This guide is part of our Intervention Toolkit which profiles innovative models of HCV care and offers guidance on how to set up different interventions for HCV in your service.

What is Point-of-Care HCV Antibody Testing? 

Definition

A point-of-care test is a test that is performed close to or near where a person is receiving care, has a fast time to result, and may lead to an immediate and informed change in client management. Thus, potentially reducing the number of visits encouraging increased linkage to care.

Point-of-care testing can enhance your model of care by reducing the barriers people may face to getting tested. Point-of-care tests can use multiple sample types including serum, plasma, venous whole-blood, capillary whole-blood and oral fluid, and can test for a variety of illnesses.

In this How-To Guide, we will focus on HCV antibody point-of-care tests, (also called rapid diagnostic tests), designed to detect HCV antibodies. Most HCV antibody point-of-care tests are run using a capillary whole-blood sample which is collected using a lancet (a special medical blade with a sharp point) to prick a finger. Usually only a few drops are needed, and it does not require a lab technician, medical professional or phlebotomist. Some point-of-care tests can also detect HCV antibodies using an oral fluid sample. Point-of-care HCV antibody testing affords ease of sampling and provides results quickly – usually in 5 to 2O minutes depending on the test used. The result generally takes 20 minutes for a negative test result and 5-20 minutes for a positive test result, depending on the test used. 

Similarly, to laboratory testing, if a point-of-care HCV antibody test is positive, it means that the person has been exposed to hepatitis C, they may have been treated and cured or their immune system may have responded successfully and cleared the virus. A positive point-of-care HCV antibody test does not mean the person has hepatitis C. In order to confirm if the person has hepatitis C, they must complete a diagnostic, or confirmatory test (also called an RNA or PCR test). Confirmatory testing is conducted to see if the virus is present and is done by a phlebotomist or medical professional who collects a blood sample and sends it for laboratory testing. In some cases, dried blood spot (DBS) testing or point-of-care testing for HCV RNA  are used to conduct confirmatory testing in community settings.

The point-of-care HCV antibody tests that are currently available have a similar sensitivity and specificity to commercial laboratory-based HCV antibody enzyme immunoassays. Despite the high sensitivity and specificity they are not licensed for use in all jurisdictions. The point-of-care HCV tests which may be available will be dependent on your region – approval for use will depend on local regulatory bodies. The World Health Organisation’s list of prequalified in vitro diagnostic products provides a comprehensive list of all WHO prequalified products including point-of-care HCV antibody tests. 

How does it work?

 

Point-of-care testing interventions can be used by a wide range of service providers to test people who may be at risk in community settings. This includes a range of non-medical settings such as at outreach events, in mobile vans and at community centres. Point-of-care HCV antibody testing can be done by medical or non-medical staff such as peer support workers, case managers, health educators and/or outreach workers. They are often used as a screening tool for people whose HCV status is unknown. In high prevalence settings where there is a strong likelihood that a person has previously been exposed to HCV, skipping the antibody test and performing an RNA test may be preferred (see: What does the evidence say?).

The steps required to perform point-of-care HCV antibody testing will depend on the specific test being used. Refer to the product information sheet and instructions for details on how to perform the test you have chosen to use in your setting. In general, tests involve obtaining a sample, usually either by pricking the finger with a lancet to obtain a small volume of blood or swabbing inside the mouth between the teeth and gums to collect an oral fluid specimen. Some tests can also be performed using a venipuncture sample. The sample is added to the sample pad/well with a buffer and results are read within 5-20 mins depending on the test type used.

There are three possible antibody test results:

1. Non-reactive or negative 

If the point-of-care HCV antibody test is negative, the person has most likely, never been exposed to HCV. A person with recent risks for possible exposure to HCV (up to 12 weeks before being tested) should be re-tested in 3 to 6 months as there is the possibility that HCV antibodies have not yet been produced, in response to an exposure. HCV RNA is detectable sooner after exposure than HCV antibodies.

2. Reactive or positive

If the point-of-care HCV antibody test is positive, the person was, or is currently, living with HCV. Once someone is exposed to HCV, they will always have antibodies to HCV in their blood. This is true if they have cleared the virus, have been cured, or still have the virus in their blood. Any person who has a positive antibody test must be referred for confirmatory RNA testing to confirm active infection and, then if RNA positive, referred for treatment.

3. Invalid 

A test may also show as invalid. This is when no control line appears regardless of whether a line is present or not on the sample line/window. If the point-of-care antibody test is invalid, this may be due to a faulty test kit or user error. Refer to the product information insert in your test kit for further guidance and information.

Costs and Settings:

  • Point-of-care HCV antibody testing is cost-effective and can be used with priority populations in non-traditional settings.
  • Improves HCV targeted health promotion strategies such as awareness screening campaigns.
  • Point-of-care HCV antibody testing can be provided in community-based settings such as on a mobile van, at an outreach event or a community centre.
  • Provides the opportunity for engagement in harm reduction information and provision of HCV transmission, testing, and treatment information (5-20 minutes) while the test develops, potentially reducing the incidence and future prevalence of HCV.
  • The test kit is portable and can be used if a table is set up in a park or at an outreach event, however there is a need for a private area to provide results confidentiality.

 

Easier for people at risk of HCV:

  • For the client, point-of-care antibody testing is less-invasive, there is no need for blood to be taken through the vein, which is helpful for people who may have a fear of needles or may have difficult veinous access. Point-of-care testing also supports the harm reduction principle of working with people where they are at (e.g. in the community and not necessarily seeking care in traditional medical settings).
  • Several studies indicate that self-testing using point-of-care HCV antibody tests has high acceptability and usability in key populations providing further potential avenues for use.

 

Quick time to result:

  • Consumers can receive test results quickly (5-20 minutes) and if implemented at the point of care along with confirmatory testing, can reduce the number of visits for the client and facilitate same day treatment. 

 

Staff Training and Equipment:

  • Unlike traditional laboratory testing requiring blood draw, cold storage and specialized equipment, point-of-care HCV antibody testing requires minimal equipment and consumables. Staff who are non-specialists can be taught by online training videos and other learning resources. Manufacturers may also provide training. There are no staff requirements for professional licenses or degrees.
  • Pre and post-test discussion training for workers ensures best practice outcomes for people being tested
  • Most point-of-care HCV antibody tests and reagents can be stored and operated at room temperature and don’t require cold chain management.

  • Point-of-care HCV antibody testing does not provide confirmation of current or active infection. It only screens for the antibodies to HCV and if positive, additional testing to confirm current HCV status and provision of treatment if required.
  • In some jurisdictions, point-of-care HCV antibody tests are not licensed for use. However, they can be used in a research setting subject to certain criteria.
  • Proper disposal of biohazard waste is required for all items that may have come in contact with the sample for example, lancet, test and gloves.
  • Depending upon the setting and the test used, waiting up to 20 minutes may be too long for some people.
  • Window period – If an individual has recently been exposed to HCV and is in the early stage of infection, their HCV antibody level may still be undetectable, thus potentially leading to a false negative result on a HCV antibody point-of-care testing.
  • Although HCV point-of-care antibody tests have a high sensitivity and specificity the point-of-care HCV antibody test may not be adequate for some people who have a low number of antibodies or compromised immune system. See section: What Does the Evidence Say for further information regarding the sensitivity and specificity of point-of-care HCV antibody testing 

Good practice examples

How to guide

How to set up point-of-care HCV antibody testing in your service

Availability: Check whether point-of-care HCV antibody testing is available and approved for use in your region. Contact your local health department or local HCV/HIV organizations to find out more.

Contact the Manufacturer: Check to see if point-of-care HCV antibody test kits can be purchased and shipped to your location.

Government Certificates or Registration: Your organizations may be able to apply for a waiver or other certification to perform simple laboratory tests like rapid tests. As an example, in the United States, organizations need a CLIA waiver which is a US Food and Drug Administration (FDA) Clinical Laboratory Improvement Amendment (or “CLIA”), which categorizes diagnostic tests by their degree of complexity and designates some non-medical settings to be “waived” which allows them to conduct diagnostic tests. Depending on your jurisdiction, you may be able to apply to use an unapproved device or an approved device in a non-medical setting. Check with your local regulatory body for further details.

Community Engagement: Include community such as local hepatitis organisations, local providers and other stakeholders in discussions that address whether the model of care you have selected in relation to point-of-care HCV antibody testing it is appropriate.

 

Helpful resources:

Key stakeholders: Identify people in your organisation or setting who need to agree to adopt point-of-care HCV antibody testing

Evidence: Write a list of reasons why they should support this initiative – highlight the benefits. Benefits of point-of-care HCV antibody testing:

  • Cost-effective
  • Minimal staff training, technical processes and infrastructure needed. Can train multiple staff to conduct point-of-care HCV antibody testing.
  • Test can be performed in many different settings by non-clinical personnel.
  • Quick access to test results which makes it easier to link those who have detectable HCV antibodies into further HCV care and treatment.
  • Conducting point-of-care testing at locations that HCV priority populations attend can reduce the number of people requiring HCV treatment becoming lost to follow-up. 
  • Often preferred by people at risk of HCV therefore providing a more person-centered model of care.
  • Improves accessibility and HCV screening rates which informs the overall epidemiological profile in the setting or country.

 

Risk Management: Show your key stakeholders that you have thought about the risks. Identify any possible risks and demonstrate how you will manage them.

Workflow: Consider how the current workflow in your setting can be adapted to incorporate point-of-care antibody testing including how individuals who return a positive result can easily and promptly linked for confirmatory testing and further care.

Budget: Put together a budget to show how much it will cost. Consider comparing the cost per test kit to traditional testing methods in your region.

Infrastructure: Identify what additional equipment and space you will need. Is there existing infrastructure you could use? Identify an area to store the test kits and HCV controls, considering any temperature stability.

Staff: Consider how you will staff the addition of point-of-care HCV antibody testing to your model of care. Can it work with your existing staff? Peer workers, case managers, and other non-clinical staff can easily be trained to conduct point-of-care testing, and if multiple staff are trained, you will be able to conduct a higher volume of tests.

Training: Consider how you will train your staff. Who will conduct the training? Training for point-of-care HCV antibody testing can be facilitated by the local health department, HCV/HIV organisations, or testing kit manufacturer. Plan for updating staff trainings over time- training costs should also be considered in the budget.

Helpful resources:

Setting up the space: A range of supplies are needed in order to conduct point-of-care HCV antibody testing safely. Universal precautions require the safe handling of any body fluids, including blood. You need a table or a flat surface to conduct testing that can be wiped clean and sanitized in between each person who is tested. You will need a way to dispose of medical waste as well as other waste generated by the testing.

General supplies needed include: Disinfectant wipes, hand sanitizer, band-aids, cotton or gauze pads, disposable gloves; hazardous waste containers for biohazards, sharps container for lancets and blood collection tool, timer, disposable absorbent bench cover and trash bags.

Testing supplies needed and storing conditions: Test kits need to be ordered and properly handled. You will need test kits and reagents (chemical solution that react to a client’s sample). You may need HCV controls, thermometer and refrigerator for proper storage of HCV controls, kits and reagents. Before ordering your point-of-care antibody tests, check the expiry with your local supplier – some tests have a relatively short shelf life and you may need to adjust your order number accordingly.

Elimination goals: Consider linking point-of-care HCV antibody testing to state, national or international strategic hepatitis elimination plans or goals 

Risk management: Show management that you have thought about any possible risks. Identify any possible risks and demonstrate how you will manage them. 

Budget: Put together a budget to show how much it will cost. Consider comparing the cost per point-of-care test and compare this to traditional testing methods.

Staff, workflow and impact: Consider how you will staff the intervention. Can it work with your existing staff? Identify key staff who will be involved.

Helpful resources:

Record keeping: Decide how you will approach record keeping, so that you can easily identify who has been tested and where they are up to in the testing process. Ensure staff are trained on proper record keeping and able to conduct routine quality assurance checks.

Client data storage: Consider where you will store client results for future reference – do you have client files already, or will you need a system to support this? Record if test was conducted during outreach or onsite, who conducted the test, when the sample was collected, and test results. You may want to consider working with a healthcare provider who has an existing electronic medical record system (if available in your country) to ensure the quality of your documentation. Ensure client confidentiality and privacy of data collection.

Policies and guidelines: Consider whether you will need to update any existing policies or guidelines within your organisation to include point-of-care HCV antibody testing.

Instruction manual: Consider whether you will need an instruction manual. You might be able to get this from your test kit supplier or adapt existing user manuals from other services. Consider the audience of your instruction manual – will it be clinical staff, peers and peer workers or clients? Adapt your communication style for the audience. A flow chart is often useful to provide a visual reference and if appropriate, include a troubleshooting section. You may need to include translation costs in your budget and training for staff to interpret / train other staff in local languages and dialects.

Consent forms: Make sure you have appropriate consent forms that outline what the testing process is, what the results mean, and possible risks so that your client can make an informed decision.

Who will organise the supplies? Identify who will be responsible for ordering and restocking test kits and other supplies needed including gloves, hand sanitizer, cleaning supplies, trash bags and biohazard containers.

Who will perform the test? Identify who will perform the test which could include a nurse, physician, other health workers including peer workers, or other staff depending on the setting.

Who will provide the results? Identify who will deliver results to your clients. Make sure they are adequately trained, maintain client confidentiality, are community-friendly, and are provided with regularly scheduled supervision sessions.

How will you provide the results? Test results should be given in-person and should provide information on risk reduction and prevention to everyone that tests and should include a referral for confirmatory testing for anyone who tests positive. For anyone that tests positive, consider reflex testing if available.

How will you link clients into treatment? Consider how you will link clients to confirmatory RNA testing if they receive a positive result. Consider location of confirmatory testing and if possible, develop plans to enable transportation or accompany people in need of confirmatory testing to the lab or medical setting. In high burden settings, consider reflex testing if available, and consider other ways to bring point-of-care confirmatory testing to the client rather than transporting the client.

Training: You may need to consider training the relevant individuals on: 

  • How to perform the collection 
  • How to interpret the results
  • Infection control
  • Client education and support including treatment literacy 

 

Resources: Consider the tools that will support your staff and clients – these may include:

  • Laminated infographics or directions to show the client how the process works
  • Client info sheets
  • Tutorials or clips- consider use of visuals and storytelling
     
Helpful resources:

Who will you test: Will you use point-of-care HCV antibody testing for all clients, or just for specific populations/situations? If testing is only being used for specific populations, ensure you have a written protocol that records this, and that everyone involved is aware of this. HCV point-of-care tests can be especially helpful for people who are actively using or injecting drugs, people in substance use programs, people in correctional settings; or shelters serving unstably housed people where they may have limited access to medical care and where the client population is less likely to come back days later to get results of a traditional blood test.

Risk Assessment: Develop a brief screening questionnaire to establish risk of infection if you don’t already have one. This can include most common transmission risk factors such as sharing unsterile injecting, snorting, or other drug using equipment that may come in contact with blood or dried blood droplets. Also focus on populations most vulnerable to HCV due to syndemic factors such as people living with HIV/AIDS, history of incarceration, homelessness, men who have sex with men, pregnant persons, and people who may have had blood transfusions among others.

When will you offer a test? Decide when to offer a client a test – is there a logical point in your interactions with people at which you can ask whether they would like one?

Where will you collect the sample? For on-site sample collection: Arrange a private area with cleanable surfaces that’s suitable for sample collection and consultation including delivering the result.

How will you provide results? Consider how you are going to provide test results to people. Point-of-care HCV antibody test results should be provided confidentiality in-person along with pre and post-test counselling.

Linkage to care: Identify the plan to link into confirmatory testing if your client gets a positive HCV result. Are there point-of-care options available in your region to test for RNA, or is traditional phlebotomy (drawing of blood by venipuncture) required? Consider whether that pathway will work for most of your clients – will some require extra help? Can your organization pay for transportation or accompany them to confirmatory testing if needed? Consider reflex testing and ways to bring point-of-care confirmatory testing to the client.

Re-testing: Decide how often you will offer re-testing. If client was recently exposed to HCV they might not have antibody levels high enough to be detected by a point-of-care test. They should wait 8-12 weeks to be re-tested for HCV antibodies. If client was not recently exposed to HCV infection, re-testing should be offered every 6 months or once a year, depending upon your agency protocols and the risks for each client. In some instances, re-testing may be offered more frequently, depending on individual circumstances. Ensure there is a pathway to treatment for each time someone is re-tested / diagnosed. Reinfection should not be a reason to exclude someone from retreatment.

Helpful resources:

Select implementation strategies: There are evidence-based strategies (methods, techniques) that you can use to promote and support the implementation and sustainability of point-of-care HCV antibody testing in your service. Here are a few examples:

  • Build a coalition: Recruit and cultivate relationships with partners in the implementation effort. Are there existing local events or other services where you could create a partnership to offer a point-of-care antibody testing service? For example, local shelters, drug treatment clinics, Sexual health/ HIV services, outreach services, etc.
  • Identify and prepare champions: Identify and prepare individuals who dedicate themselves to supporting and advocating for implementation to overcome indifference or resistance. These champions can get the word out and increase awareness in your local population.
  • Involve clients: Engage or include clients and families in the implementation effort to highlight positive experience. Can you create a narrative of positive experiences from people who have taken the test? This should be a pillar in any service or hepatitis C program to ensure community engagement, which may include (but not limited to) support groups, community consultation processes, community advisory boards, and to ensure community leadership in the planning, design, development, implementation and monitoring aspects throughout the HCV care cascade
  • Involve and train peers: Engage or include (and fairly remunerate ) trained peers in your model of care and in the implementation effort of point-of-care testing. Peers can provide support, promote testing and collect samples if they are trained. Peer workers bring unique and valuable expertise, skills, experiences and communication strategies to the support, testing, sample collection, counselling processes, with appropriate training.
  • Conduct educational meetings: Hold meetings with different stakeholder groups (e.g., providers, policy & decision-makers, administrators, and community, client, and family stakeholders) to educate them about point-of-care antibody testing. Consider incorporating point-of-care HCV antibody testing into a health promotion campaign aimed at increasing awareness of HCV. This could be done in conjunction with events such as World Hepatitis Day.
  • Conduct local consensus discussions: Include local providers and other stakeholders in discussions that address whether the model of care you have selected, in relation to point-of-care HCV antibody testing, is appropriate. Include community friendly providers and peer workers trained in mitigating stigma and discrimination when providing screening services.
  • Develop and disseminate educational materials: Develop and format toolkits and other supporting materials such as video tutorials (in addition to the instruction manual) for stakeholders to learn about point-of-care HCV antibody testing.

 

Helpful resources:

Evaluation plan: Plan how you will evaluate the uptake and effectiveness of the intervention. How will you know if the intervention has been useful? This will also help you to identify any gaps or areas where you can improve your point-of-care pathway. 

Challenges and barriers you might encounter and how to overcome them

Contact your local health department or HIV/HCV service organization to find out if point-of-care HCV antibody testing is available in your region.

If they can’t point you in the right direction, contact us and we’ll do our best to help.

A World Health Organisation list of prequalified in vitro diagnostic products including point-of-care HCV antibody tests provides a comprehensive list of assays and their manufacturers.

If point-of-care HCV antibody testing is not available in your region, develop relationships with local hospitals or clinics and other community health settings so that your clients can be referred there for antibody and confirmatory RNA testing. If you have a relationship with a research organisation invested in HCV, enquire if they have any research studies involving point-of-care HCV antibody testing that your service can take part in.

Point-of-care HCV antibody testing is cost-effective, and you can train multiple staff to conduct testing. It is easily accessible for some of the most marginalised, stigmatised, under-served populations who might not otherwise access HCV testing

Contact other services who have successfully implemented point-of-care testing and ask them for advice. Use your networks to promote use, and ask peers, clients, and staff to promote it. 

See our ‘What does the evidence say?’ section for examples on the impact point-of-care HCV antibody testing has had at other services.

Contact other services who have successfully implemented point-of-care HCV antibody testing and ask them for advice. You might not need funding – initiatives may be available or subsidised by governments or health departments. If not, depending on the type of organization you are in, you may be able to seek grants to support implementation; contact your local health department to seek funding opportunities or advocate for state and local health departments to allocate resources to fund hepatitis programs. Approaching pharmaceutical companies working in HCV may also be a possibility.

Free training on how to use the point-of-care test kits is available from the manufacturers.

Rather than seek funding for a permanent program, consider approaching management for a pilot project with agreed upon endpoints and metrics that will help objectively show whether there is a benefit or not by using point-of-care testing. Find examples of research that has demonstrated the benefits to clients.

 

Helpful resources:

Staff can be trained by the health department, HIV/HCV organizations, or testing kit manufacturers.

Helpful resources:

Plan to have HCV educational materials and testing information in different languages and/or an interpreter available to translate. There should be a link to live counsellors who can provide information, link to care, interpret results in local languages, which may include a hotline, app, buddy system, or other models that ensure language justice.

Helpful resources:

If possible, set up a private area or workspace for point-of-care HCV antibody testing to ensure client confidentiality. This includes ensuring the client can make informed decisions.

It is important to maintain accurate record keeping of number of test kits used and results in order to track screening outcomes.

It is important to track testing kits and routinely check expiration dates upon receipt and on an ongoing basis. Knowing the consumption of your service will help in estimating the quantity of test kits to buy and ordering in advance is necessary to have a healthy stock of testing supplies.

Organizations need a place to store testing kits at a proper temperature and a refrigerator may be needed to store the HCV controls at appropriate temperatures.

 

Resources

Disclaimers 

*The following disclaimers refer to the resources listed above which are utilised as part of the National Australian Hepatitis C Point-of-Care Testing Program. 

  1. Point-of-Care testing must only be performed by trained and competent operators.
  2. Research Use only refers to this assay not being certified by the Therapeutic Goods Administration (TGA) as in vitro medical device.

Frequently asked questions

What is a point-of-care test?  

A point-of-care test is a test that is performed close to or near where a person is receiving care, has a fast time to result, and may lead to an immediate and informed change in client management, potentially facilitating a reduced number of visits leading to increased linkage to care.

Does the client need to have venepuncture?  

No, the test uses capillary blood from a finger prick. 

How long does the test result take to be available?  

The result is available usually in 5-20 minutes depending on the test used. 

 

Got a question?

Contact us and we’ll do our best to help. 

Top tips for implementing point-of-care HCV antibody testing in your service

Create a small working group to help develop a point-of-care HCV antibody testing project

Include peers, peer workers, community leaders, people with lived experience or from affected communities in your model of care and working group

Get management on board. Invite speakers to demonstrate how it will benefit your service and community. Show examples of where it has worked elsewhere

Work out a budget and show how point-of-care HCV antibody testing can be cost effective and save money

Evaluate what you are doing – it is important to track results related to how many people were approached or offered testing, how many tested, how many identified to have HCV antibodies and how many of those were referred for confirmatory testing

Create and maintain strong relationships with clinics or laboratory services so that you have places to refer people for confirmatory testing. Find ways to bring point-of-care confirmatory testing to people.

Stay in touch with organisations who can support and encourage you – organise monthly meetings, online or in person.

Find a champion who can tell their story. This could be a client who is willing to share their story, or another site that has already implemented point-of-care antibody testing at their service 

Write up your experience and share it with others. Find creative ways to share experiences such as through video formats, storytelling etc.

What does the evidence say? 

Impact of point-of-care HCV antibody testing on testing and linkage to treatment:

Title
Author 
Year
Link
Usability and acceptability of oral-based HCV self-testing among key populations: a mixed-methods evaluation in Tbilisi, Georgia Fajardo E, et al 2022 Read the paper
Values and preferences for hepatitis C self-testing among people who inject drugs in Kyrgyzstan Martínez-Pérez G, et al. 2021 Read the paper
Usability and acceptability of self-testing for hepatitis C virus infection among the general population in the Nile Delta region of Egypt Reipold E, et al.  2021 Read the paper
Acceptability and Usability of HCV Self-Testing in High Risk Populations in Vietnam Nguyen L, et al.  2021 Read the paper
Rapid Versus Laboratory-Based Testing for HIV and Hepatitis C at a Drug Detoxification Treatment Center: A Randomized Trial Assoumou S, et al. 2020 Read the paper
Impact of routine opt-out HIV/HCV screening on testing uptake at a syringe services program: An interrupted time series analysis Bartholomew T, et al.  2020 Read the paper
Simultaneous Human Immunodeficiency Virus- Hepatitis B-Hepatitis C Point-of-Care Tests Improve Outcomes in Linkage-to-Care: Results of a Randomized Control Trial in Persons Without Healthcare Coverage Bottero J, et al.  2020 Read the paper
Peer outreach point-of-care testing as a bridge to hepatitis C care for people who inject drugs in Toronto, Canada Broad J & Mason K, et al.  2020 Read the paper
Bundling Rapid Human Immunodeficiency Virus and Hepatitis C Virus Testing to Increase Receipt of Test Results Frimpong J, et al.  2020 Read the paper
Point-of-care hepatitis C testing from needle and syringe programs: An Australian feasibility study Williams B, et al  2019 Read the paper
Integrating HCV testing with HIV programs improves hepatitis C outcomes in people who inject drugs: A cluster-randomized trial Solomon S, et al.  2019 Read the paper
Point­ of-­care tests for hepatitis B and C infection are associated with a higher linkage to care in an Asian migrant population Ho E, et al.  2018 Read the paper
Management of hepatitis C in decentralised versus centralised drug substitution programmes and minimally invasive point-of-care tests to close gaps in the HCV cascade Bregenzer A & Cohen C,  et al. 2017 Read the paper
Strategies for Hepatitis C Testing and Linkage to Care for Vulnerable Populations: Point-of-Care and Standard HCV Testing in a Mobile Medical Clinic Morano J, et al. 2014 Read the paper
Impact of Rapid Hepatitis C testing on Receipt of Hepatitis C Results in a Public STD Clinic
Falade-Nwulia O, et al. 
2014 Read the paper

Technical validation – sensitivity and specificity of point-of-care HCV antibody testing:

Sensitivity and specificity of rapid hepatitis C antibody assays in freshly collected whole blood, plasma and serum samples: A multicentre prospective study
Vetter B, et al. 
2020 Read the paper
Sensitivity and specificity of rapid diagnostic tests for hepatitis C virus with or without HIV coinfection: a multicentre laboratory evaluation study
Vetter B, Reipold E, Ongarello S, et al. 
2020 Read the paper
Diagnostic accuracy of tests to detect Hepatitis C antibody: a meta-analysis and review of the literature Weiming T, et al.  2017 Read the paper

Implementation theories:

Title
Author
Year
Link
Making sense of implementation theories, models and frameworks Nilsen P. 2015 Read the paper
A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project Powell B, et al.  2015 Read the paper
Effective Practice and Organization of Care (EPOC) Shepperd S, et al.  2015 Read the paper

 

Photos used with permission from the Kirby Institute, UNSW, Sydney, Australia, Vacseen Team and Actors Fund