Theme: Epidemiology & Public Health Research Year: 2019
Background: The advent of direct-acting antivirals and point-of-care (POC) testing platforms for
hepatitis C (HCV) allow for the decentralization of care into community settings. In Myanmar, and
globally, access to DAAs is generally limited to tertiary hospitals and private sector; if we are to reach
all living HCV we must expand HCV services into community settings.
Methods: Effectiveness-implementation hybrid trial of community-based POC testing and DAA
therapy for HCV among people who inject drugs (Thingangyun Clinic – Burnet Institute) and general
population (Than Sitt Charity Clinic – Myanmar Liver Foundation) in Yangon, Myanmar.
Rapid diagnostic test for anti-HCV antibodies is performed on-site; if reactive, POC Xpert HCV VL test
is performed on-site. External laboratory investigations are returned to the participant next day with
participants commencing DAA therapy on the same day if no complications requiring specialist
review.
Clinical data are collected in case report forms and behavioral surveys are completed by participants.
Preliminary results from first 200 participants will be presented: demographics, risk behaviors, HCV
positivity and treatment uptake.
Results: To date, 154 participants have been enrolled (n=81 at Thingangyun; n=73 at Than Sitt).
At Thingangyun, 95% (n=77) are male, all reported lifetime injecting and 95% (n=77) had injected in
past six months. Anti-HCV antibody positivity was 96% (n=78) and RNA positivity was 91% (n=71). At
Than Sitt, 36% (n=26) are male and one reported lifetime injecting. Anti-HCV antibody positivity was
95% (n=70) and RNA positivity was 90% (n=63).
Conclusion: Initial results suggest that providing POC testing on-site in community-based settings
may led to high retention in care to diagnosis among people who inject drugs and general
population equally; addition of treatment uptake data in presentation will allow for further retention
in care analysis. Evidence from this study will inform the scale-up of hepatitis C treatment programs
in Myanmar and globally.
Disclosure of Interest Statement: This study is funded as part of the Unitaid funded Foundation of
Innovative and New Diagnostics (FIND) Hepatitis C Elimination through Access to Diagnostics (HEADStart) project.
BL Draper receives postgraduate scholarship from the Australian National Health and Medical
Research Council (NHMRC). ME Hellard investigator-initiated research funding to institution from
Gilead, Merck, AbbVie and BMS. J Howell receives investigator-initiated research funding to
institution from Gilead