Theme: Clinical Research Year: 2024
Background: Fingerstick point-of-care HCV RNA testing enables diagnosis and treatment in a single-visit, increases testing acceptability, and reduces loss to follow-up. We evaluated RNA prevalence and treatment uptake (and associated factors) in a national program to scale-up point-of-care HCV testing.
Methods: The National HCV Point-of-Care Testing Program is evaluating scale-up of point-of-care HCV testing through an observational study at sites in all states/territories in Australia. Point-of-care testing is provided for people at HCV risk or attending a service providing care for people at HCV risk. Factors associated with HCV treatment uptake were identified through logistic regression analyses. The proportion of people receiving HCV treatment from January 2022-December 2023 among all people treated in Australia was assessed.
Results: From January 2022-June 2024, 98 sites (community, n=60; prison, n=38, 420 locations) provided testing (313 operators trained). 25,531 HCV point-of-care tests were performed (antibody, n=7,774; RNA, n=17,757), with 10,534 people tested in community and 11,349 in prison. Among those enrolled, 2,779 (14%) had current HCV infection (community, 10%; prison, 17%). Among the evaluable population (reached 12 weeks post-testing), HCV treatment uptake was 78% (1,853/2377), including 51% (391/770) in community and 91% (1,462/1,607) in prison. Among people with current HCV in the community, people with >daily injecting drug use in the last 30 days (aOR 0.49, 95% CI: 0.31, 0.75) and people tested through mobile outreach [compared to drug treatment services; aOR 0.17 (95% CI: 0.05, 0.53)] had a lower odds of HCV treatment. Among all people treated for HCV in 2023 in Australia, 10% (821 of 8,382) were treated through the program.
Conclusion: Onsite point-of-care HCV testing has led to high treatment uptake, particularly in prison settings in Australia.
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