Theme: Epidemiology & Public Health Research Year: 2016
HEPATITIS C TESTING IN THE GENERAL PRACTICE SETTING FOR AUSTRALIANS WHO INJECT DRUGS
Butler K1, Day C2, Burns L1, Larney S1
1 National Drug and Alcohol Research Centre, UNSW Australia
2 The University of Sydney, Australia
Background: The recent introduction of subsidised direct acting anti-virals (DAAs) for all people with chronic hepatitis C (HCV) in Australia, along with the provision for general practitioners (GPs) to prescribe DAAs in consultation with a specialist, is expected to bolster access to HCV treatment. This is especially true among people who inject drugs (PWID), the group most affected. Yet there is increasing evidence that this group frequently do not receive complete testing, i.e. confirmatory polymerase chain reaction (PCR) testing following positive HCV antibody (anti-HCV) testing. We aimed to determine the proportion of PWID who received complete testing in the GP setting compared to those tested at other sites (e.g. specialist or targeted).
Methods: The Illicit Drug Reporting System (IDRS) is an annual illicit drug sentinel surveillance system. We interviewed 100-150 people who regularly inject drugs in each Australian capital city. All participants received AUD$40 for survey completion. Interviews included questions on HCV testing and treatment settings.
Results: The majority of participants (93%) reported anti-HCV testing. Most participants identified their regular GP (52%) as ordering the most recent anti-HCV test with the remainder reporting testing being done at other sites. Confirmatory PCR testing was self-reported by 62% of those who reported being anti-HCV positive. The most common setting reported for this test was their regular GP (46%). The proportion of PWID who reported receiving PCR testing from their GP (63%) was similar to PCR testing at other services (62%), indicating a substantial minority receive incomplete testing.
Conclusion: HCV testing was most frequently undertaken by participants’ regular GP. These findings suggest that GPs are currently providing PCR testing similar to other services, although more than one-third of anti-HCV positive PWID are receiving incomplete testing, a situation which urgently needs to be rectified before DAAs can have a population benefit.
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