Hep C elimination needs point of care testing

Point of care testing has the potential to help get more people with hepatitis C identified and ready for treatment – however it’s just not quite there yet.

Dr Joseph Doyle told the Australasian Society for Infectious Diseases (ASID) Annual Scientific Meeting that the tests had to be faster to engage more people via opportunistic testing.

The Rapid-EC study, a feasibility study at three community centres in inner Melbourne, offered clients a 20-minute HCV antibody test and if positive, a HCV RNA test which took about 105 minutes.

Patients were mostly men (69%), with an average age of 41 years. who  were presenting to the centres for services such as methodone treatment or counseling.

Dr Doyle, from Monash University’s Department of Infectious Diseases and head of viral hepatitis elimination at the Burnet Institute, said only 5% of clients were prepared to wait on site for the results.

However most (74%) did attend for follow up within 11 days of the opportunistic testing.

“The message for specialists is that we can deliver a rapid test in the community and it looks like it does increase the number of people who get tested and it shortens the time it takes for them to get to care where they can get their HCV treatment done,” he told the limbic.

Most participants (90%) said they were very happy with the process, particularly that peers and community workers were involved rather than health professionals.

About 86% of the cohort were HCV positive including many who reported they had previously received positive reports but had not accessed treatment.

“There are two things about point of care tests which I think will be helpful for trying to get to HCV elimination. The first is it will diagnose some people who don’t yet know their status but 44% had had a previous test and were viraemic and hadn’t been treated.”

“So the second thing is it will help get people to care because it is an immediate reminder that they’ve still got a virus.”

He said at least 30 products for point of care testing were available – most with good sensitivity and specificity.

“However the current diagnostics we have at the point of care level may not be the whole answer. They need to be quicker so then the patients can get answer quickly. If they have to wait too long, it loses some of its advantage.”

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