Author: Craig J, Brown T, Chkrebtii N, Ricciuto D, Bailey C, Carr K, Boyd P

Theme: Epidemiology & Public Health Research Year: 2019

Background: Forty-four percent of hepatitis C virus (HCV) infections in Canada are undiagnosed, with
the highest risk in people who use drugs (PWUD). Ministry of Health-defined priority populations are
disproportionately affected and experience barriers limiting access to care. We aimed to prospectively
determine the impact of access to point of care (POC) HCV testing in outreach settings on priority
Methods: From July 2017 to December 2018 a registered nurse offered POC HCV testing using the
OraQuick® HCV Test to priority individuals of unknown HCV status at six outreach locations that
provided meals and support. Participants confirmed verbal consent using an REB-approved script and
underwent on-site POC testing. All participants received HCV education and harm-reduction counselling.
Those with a positive POC result were offered on-site confirmatory serologic testing and
multidisciplinary follow-up at our Positive Care Clinic (PCC). Participants and health care personnel were
surveyed on their experiences.
Results: POC testing was provided to 137 participants (72% PWUD). Nineteen participants (14%) had
reactive POC testing, of which eight (42%) underwent confirmatory serology. Four participants engaged
in care at PCC.
All participants responded favorably to POC testing. Nearly all participants indicated little to no pain
(142/144, 99%), bleeding (141/142, 99%), or anxiety (137/142, 96%). All health-care personnel found
the test easy to administer.
Conclusion: Application of POC testing in an outreach setting allowed for rapid HCV testing and
counselling of high-risk individuals. This alone might trigger behaviour change, prevent transmission and
reduce stigma associated with testing. Testing was safe, easy to administer, and transportable to nontraditional healthcare settings. We confirmed a high prevalence of HCV in priority populations, including
PWUD. Yet, only 21% of patients with positive POC tests engaged in further care, highlighting a major
barrier to treatment. Strategies to promote ongoing engagement need to be evaluated, including
Telehealth and outreach physician appointments.
Disclosure of Interest Statement:
Medical Project funding received from Gilead Sciences Canada, Inc. Gilead Sciences had no input into
the design, implementation, or writing of this research study.

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