Abstract
Background: The WHO has set a goal to eliminate HCV as a public health threat by 2030, with targets to increase HCV
diagnoses and treatment, and reduce new infections and liver-related deaths. Increasing uptake of HCV testing is
hampered by current diagnostic pathways requiring multiple visits and frequent loss to follow-up, amplified in key target
populations, such as people who inject drugs. Point-of-care fingerstick HCV RNA testing enables diagnosis and treatment
in a single-visit, increases testing acceptability, and reduces loss to follow-up, addressing the drop-off in the HCV care
cascade.
Objectives: This partnership project will evaluate a national program to facilitate the scale-up of point-of-care HCV testing
in Australia.
Methods: This project is establishing point-of-care HCV testing (antibody and RNA) at 65 services nationally, including
drug treatment clinics, needle and syringe programs, prisons, mental health settings, homelessness settings, Aboriginal
Community Controlled Health Organisations, and mobile outreach clinics. Between December 2021-23, 50-60,000 pointof-
care HCV tests will be performed. This project will assess reach, effectiveness, adoption, implementation, and
maintenance of HCV point-of-care testing, including an evaluation of the cost-effectiveness, affordability and long-term
epidemiological impact of scaled-up HCV testing and treatment in key settings. An observational cohort study will be
used to assess the effect of an intervention integrating point-of-care testing and the offer of same-visit treatment on
treatment uptake and reduction in HCV RNA prevalence among people with high risk of HCV acquisition. We will also
evaluate patient, provider, and policymaker perceptions of acceptability, barriers, and facilitators for the scale-up of HCV
point-of-care testing.
Results / Outcomes: The program has developed standard operating procedures, logistics, device deployment, and setup
for sites to establish HCV point-of-care testing as routine clinical care. A comprehensive program has been developed
for standardized remote operator training, competency assessment and quality management aligned with best practice
and regulatory standards. We have also implemented IT/connectivity systems to meet real-world, clinical (data transfer to
electronic medical records), and public health reporting needs (laboratory notifications) to improve patient safety and
linkage to care. Two sites were initiated in December 2021, 25 sites are planned for March-April 2022, and the remaining
sites by Dec 2022.
Conclusions / Lessons learnt: This project will be amongst the first internationally to evaluate the national scale-up of
point-of-care HCV testing, providing critical information on this approach towards reducing HCV prevalence in Australia.
This study will facilitate the translation of research outcomes to practice and policy, informing national and international
clinical guidelines, health service implementation, hepatitis strategies, and health policy.
diagnoses and treatment, and reduce new infections and liver-related deaths. Increasing uptake of HCV testing is
hampered by current diagnostic pathways requiring multiple visits and frequent loss to follow-up, amplified in key target
populations, such as people who inject drugs. Point-of-care fingerstick HCV RNA testing enables diagnosis and treatment
in a single-visit, increases testing acceptability, and reduces loss to follow-up, addressing the drop-off in the HCV care
cascade.
Objectives: This partnership project will evaluate a national program to facilitate the scale-up of point-of-care HCV testing
in Australia.
Methods: This project is establishing point-of-care HCV testing (antibody and RNA) at 65 services nationally, including
drug treatment clinics, needle and syringe programs, prisons, mental health settings, homelessness settings, Aboriginal
Community Controlled Health Organisations, and mobile outreach clinics. Between December 2021-23, 50-60,000 pointof-
care HCV tests will be performed. This project will assess reach, effectiveness, adoption, implementation, and
maintenance of HCV point-of-care testing, including an evaluation of the cost-effectiveness, affordability and long-term
epidemiological impact of scaled-up HCV testing and treatment in key settings. An observational cohort study will be
used to assess the effect of an intervention integrating point-of-care testing and the offer of same-visit treatment on
treatment uptake and reduction in HCV RNA prevalence among people with high risk of HCV acquisition. We will also
evaluate patient, provider, and policymaker perceptions of acceptability, barriers, and facilitators for the scale-up of HCV
point-of-care testing.
Results / Outcomes: The program has developed standard operating procedures, logistics, device deployment, and setup
for sites to establish HCV point-of-care testing as routine clinical care. A comprehensive program has been developed
for standardized remote operator training, competency assessment and quality management aligned with best practice
and regulatory standards. We have also implemented IT/connectivity systems to meet real-world, clinical (data transfer to
electronic medical records), and public health reporting needs (laboratory notifications) to improve patient safety and
linkage to care. Two sites were initiated in December 2021, 25 sites are planned for March-April 2022, and the remaining
sites by Dec 2022.
Conclusions / Lessons learnt: This project will be amongst the first internationally to evaluate the national scale-up of
point-of-care HCV testing, providing critical information on this approach towards reducing HCV prevalence in Australia.
This study will facilitate the translation of research outcomes to practice and policy, informing national and international
clinical guidelines, health service implementation, hepatitis strategies, and health policy.
| Original language | English |
|---|---|
| Publication status | Published - 25 Apr 2023 |
| Event | Global Hepatitis Summit 2023: 18th Global Hepatitis Summit (GHS 2023), a 50 years legacy of the International Symposium on Viral Hepatitis and Liver Disease (ISVHLD). - Pullman Montparnasse Paris, Paris, France Duration: 25 Apr 2023 → 28 Apr 2023 https://global-hepatitis.com/program/ (Conference web page) |
Conference
| Conference | Global Hepatitis Summit 2023 |
|---|---|
| Country/Territory | France |
| City | Paris |
| Period | 25/04/23 → 28/04/23 |
| Internet address |
|
Bibliographical note
Presented by Jason Grebely.Public Health 4, "Simplified approaches for screening and diagnosis of viral hepatitis", Day 2, Wednesday April 26, 2023, 9:50 - 10:00.
Keywords
- hepatitis C
- point of care testing
- decentralised
- treatment
