A national program to scale-up decentralized hepatitis C virus point-of-care testing and treatment in Australia

Jason Grebely; Corey Markus; Louise Causer; David Silk; Simon Comben; S Hosseini-Hooshyar; S Davey; Andrew R. Lloyd; Maria Martinez; Shaw I; Cunningham Phillip; Carrie Fowlie; Evan Cunningham; Alison Marshall; M Byrne; Carla Treloar; Sophy Shih; Richard Gray; Virginia Wiseman; Tanya Applegate; Rebecca Guy; Marianne Martinello; Behzad Hajarizadeh; Lise Lafferty; Wayne Dimich; Liza  Cabuang; P Schroder; P Read; A Pedrana; Yumi Sheehan; Alex Thompson; Joss O'Loan; Mim O'Flynn; Gregory Dore; Susan Matthews

Abstract

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, addressing the drop-off in the HCV care cascade. This analysis evaluated HCV testing and RNA prevalence in a national program to scale-up point-of-care HCV testing.

Methods: The National Australian HCV Point-of-Care Testing Program is evaluating the scale-up of point-of-care HCV testing (antibody: Bioline HCV test; RNA: Xpert HCV Viral Load Fingerstick test) at 90 sites in Australia, including drug treatment clinics, needle and syringe programs, prisons, mental health services, homelessness services, Aboriginal Community Controlled Health Organisations, and mobile outreach clinics through an observational study. The program facilitates point-of-care testing for anyone at risk of HCV or attending a service providing care for people at risk of HCV. The program also includes standardised operator training for non-laboratory staff and quality assurance program. Immediate HCV RNA testing is performed in settings with high HCV antibody prevalence (>15%, drug treatment, needle syringe programs and prisons). HCV antibody testing with reflex RNA testing is performed in settings with low HCV antibody prevalence (

Results: Between January 2022 and February 2023, 53 sites (community, n=43; prison, n=10) have been established in five states/territories (135 operators trained) with 6,653 HCV point-of-care tests performed (antibody, n=927; RNA, n=5,726) in the community (n=2,021) and prisons (n=4,261). Among those receiving HCV RNA testing, 850 people (14%) have current HCV infection (community, 10%; prison, 15%). HCV treatment uptake is 78% (662 of 850) overall and 93% (595 of 638) in prison.

Conclusion: Onsite point-of-care HCV testing has led to high treatment uptake across different settings across Australia. Standardised operator training and quality assurance have been critical for success.

Disclosure of Interest Statement: This study has received funding from the Australian Department of Health (LD21/1305), NSW Health, AbbVie, Gilead Sciences, and Cepheid. JG is a consultant/advisor and has received research grants from Abbvie, bioLytical, Camurus, Cepheid, Gilead Sciences, Hologic, and Indivior.

Original language	English
Number of pages	2
Publication status	Published - Jul 2023
Event	HIV Coinfection & VH Elimination 2023 - Sofitel Brisbane Central, Brisbane, Australia Duration: 21 Jul 2023 → 22 Jul 2023 https://ashm.eventsair.com/QuickEventWebsitePortal/avhecco-infections-2023/program (Conference program)

Conference

Conference	HIV Coinfection & VH Elimination 2023
Country/Territory	Australia
City	Brisbane
Period	21/07/23 → 22/07/23
Internet address	https://ashm.eventsair.com/QuickEventWebsitePortal/avhecco-infections-2023/program (Conference program)

Keywords

hepatitis C
point-of-care testing
decentralised
national program

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

https://az659834.vo.msecnd.net/eventsairaueprod/production-ashm-public/161fffbaac7e47fbaacd554e407b26b0Licence: In Copyright

Cite this

Grebely, J., Markus, C., Causer, L., Silk, D., Comben, S., Hosseini-Hooshyar, S., Davey, S., Lloyd, A. R., Martinez, M., I, S., Phillip, C., Fowlie, C., Cunningham, E., Marshall, A., Byrne, M., Treloar, C., Shih, S., Gray, R., Wiseman, V., ... Matthews, S. (2023). A national program to scale-up decentralized hepatitis C virus point-of-care testing and treatment in Australia. Abstract from HIV Coinfection & VH Elimination 2023, Brisbane, Australia. https://az659834.vo.msecnd.net/eventsairaueprod/production-ashm-public/161fffbaac7e47fbaacd554e407b26b0

@conference{4a55cbc3a2f94cd6a94e6eac02630abb,

title = "A national program to scale-up decentralized hepatitis C virus point-of-care testing and treatment in Australia",

abstract = "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, addressing the drop-off in the HCV care cascade. This analysis evaluated HCV testing and RNA prevalence in a national program to scale-up point-of-care HCV testing. Methods: The National Australian HCV Point-of-Care Testing Program is evaluating the scale-up of point-of-care HCV testing (antibody: Bioline HCV test; RNA: Xpert HCV Viral Load Fingerstick test) at 90 sites in Australia, including drug treatment clinics, needle and syringe programs, prisons, mental health services, homelessness services, Aboriginal Community Controlled Health Organisations, and mobile outreach clinics through an observational study. The program facilitates point-of-care testing for anyone at risk of HCV or attending a service providing care for people at risk of HCV. The program also includes standardised operator training for non-laboratory staff and quality assurance program. Immediate HCV RNA testing is performed in settings with high HCV antibody prevalence (>15%, drug treatment, needle syringe programs and prisons). HCV antibody testing with reflex RNA testing is performed in settings with low HCV antibody prevalence (Results: Between January 2022 and February 2023, 53 sites (community, n=43; prison, n=10) have been established in five states/territories (135 operators trained) with 6,653 HCV point-of-care tests performed (antibody, n=927; RNA, n=5,726) in the community (n=2,021) and prisons (n=4,261). Among those receiving HCV RNA testing, 850 people (14%) have current HCV infection (community, 10%; prison, 15%). HCV treatment uptake is 78% (662 of 850) overall and 93% (595 of 638) in prison. Conclusion: Onsite point-of-care HCV testing has led to high treatment uptake across different settings across Australia. Standardised operator training and quality assurance have been critical for success. Disclosure of Interest Statement: This study has received funding from the Australian Department of Health (LD21/1305), NSW Health, AbbVie, Gilead Sciences, and Cepheid. JG is a consultant/advisor and has received research grants from Abbvie, bioLytical, Camurus, Cepheid, Gilead Sciences, Hologic, and Indivior. ",

keywords = "hepatitis C, point-of-care testing, decentralised, national program",

author = "Jason Grebely and Corey Markus and Louise Causer and David Silk and Simon Comben and S Hosseini-Hooshyar and S Davey and Lloyd, {Andrew R.} and Maria Martinez and Shaw I and Cunningham Phillip and Carrie Fowlie and Evan Cunningham and Alison Marshall and M Byrne and Carla Treloar and Sophy Shih and Richard Gray and Virginia Wiseman and Tanya Applegate and Rebecca Guy and Marianne Martinello and Behzad Hajarizadeh and Lise Lafferty and Wayne Dimich and Liza Cabuang and P Schroder and P Read and A Pedrana and Yumi Sheehan and Alex Thompson and Joss O'Loan and Mim O'Flynn and Gregory Dore and Susan Matthews",

year = "2023",

month = jul,

language = "English",

note = "HIV Coinfection & VH Elimination 2023 ; Conference date: 21-07-2023 Through 22-07-2023",

url = "https://ashm.eventsair.com/QuickEventWebsitePortal/avhecco-infections-2023/program",

}

Grebely, J, Markus, C, Causer, L, Silk, D, Comben, S, Hosseini-Hooshyar, S, Davey, S, Lloyd, AR, Martinez, M, I, S, Phillip, C, Fowlie, C, Cunningham, E, Marshall, A, Byrne, M, Treloar, C, Shih, S, Gray, R, Wiseman, V, Applegate, T, Guy, R, Martinello, M, Hajarizadeh, B, Lafferty, L, Dimich, W, Cabuang, L, Schroder, P, Read, P, Pedrana, A, Sheehan, Y, Thompson, A, O'Loan, J, O'Flynn, M, Dore, G & Matthews, S 2023, 'A national program to scale-up decentralized hepatitis C virus point-of-care testing and treatment in Australia', HIV Coinfection & VH Elimination 2023, Brisbane, Australia, 21/07/23 - 22/07/23. <https://az659834.vo.msecnd.net/eventsairaueprod/production-ashm-public/161fffbaac7e47fbaacd554e407b26b0>

TY - CONF

T1 - A national program to scale-up decentralized hepatitis C virus point-of-care testing and treatment in Australia

AU - Grebely, Jason

AU - Markus, Corey

AU - Causer, Louise

AU - Silk, David

AU - Comben, Simon

AU - Hosseini-Hooshyar, S

AU - Davey, S

AU - Lloyd, Andrew R.

AU - Martinez, Maria

AU - I, Shaw

AU - Phillip, Cunningham

AU - Fowlie, Carrie

AU - Cunningham, Evan

AU - Marshall, Alison

AU - Byrne, M

AU - Treloar, Carla

AU - Shih, Sophy

AU - Gray, Richard

AU - Wiseman, Virginia

AU - Applegate, Tanya

AU - Guy, Rebecca

AU - Martinello, Marianne

AU - Hajarizadeh, Behzad

AU - Lafferty, Lise

AU - Dimich, Wayne

AU - Cabuang, Liza

AU - Schroder, P

AU - Read, P

AU - Pedrana, A

AU - Sheehan, Yumi

AU - Thompson, Alex

AU - O'Loan, Joss

AU - O'Flynn, Mim

AU - Dore, Gregory

AU - Matthews, Susan

PY - 2023/7

Y1 - 2023/7

N2 - 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, addressing the drop-off in the HCV care cascade. This analysis evaluated HCV testing and RNA prevalence in a national program to scale-up point-of-care HCV testing. Methods: The National Australian HCV Point-of-Care Testing Program is evaluating the scale-up of point-of-care HCV testing (antibody: Bioline HCV test; RNA: Xpert HCV Viral Load Fingerstick test) at 90 sites in Australia, including drug treatment clinics, needle and syringe programs, prisons, mental health services, homelessness services, Aboriginal Community Controlled Health Organisations, and mobile outreach clinics through an observational study. The program facilitates point-of-care testing for anyone at risk of HCV or attending a service providing care for people at risk of HCV. The program also includes standardised operator training for non-laboratory staff and quality assurance program. Immediate HCV RNA testing is performed in settings with high HCV antibody prevalence (>15%, drug treatment, needle syringe programs and prisons). HCV antibody testing with reflex RNA testing is performed in settings with low HCV antibody prevalence (Results: Between January 2022 and February 2023, 53 sites (community, n=43; prison, n=10) have been established in five states/territories (135 operators trained) with 6,653 HCV point-of-care tests performed (antibody, n=927; RNA, n=5,726) in the community (n=2,021) and prisons (n=4,261). Among those receiving HCV RNA testing, 850 people (14%) have current HCV infection (community, 10%; prison, 15%). HCV treatment uptake is 78% (662 of 850) overall and 93% (595 of 638) in prison. Conclusion: Onsite point-of-care HCV testing has led to high treatment uptake across different settings across Australia. Standardised operator training and quality assurance have been critical for success. Disclosure of Interest Statement: This study has received funding from the Australian Department of Health (LD21/1305), NSW Health, AbbVie, Gilead Sciences, and Cepheid. JG is a consultant/advisor and has received research grants from Abbvie, bioLytical, Camurus, Cepheid, Gilead Sciences, Hologic, and Indivior.

AB - 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, addressing the drop-off in the HCV care cascade. This analysis evaluated HCV testing and RNA prevalence in a national program to scale-up point-of-care HCV testing. Methods: The National Australian HCV Point-of-Care Testing Program is evaluating the scale-up of point-of-care HCV testing (antibody: Bioline HCV test; RNA: Xpert HCV Viral Load Fingerstick test) at 90 sites in Australia, including drug treatment clinics, needle and syringe programs, prisons, mental health services, homelessness services, Aboriginal Community Controlled Health Organisations, and mobile outreach clinics through an observational study. The program facilitates point-of-care testing for anyone at risk of HCV or attending a service providing care for people at risk of HCV. The program also includes standardised operator training for non-laboratory staff and quality assurance program. Immediate HCV RNA testing is performed in settings with high HCV antibody prevalence (>15%, drug treatment, needle syringe programs and prisons). HCV antibody testing with reflex RNA testing is performed in settings with low HCV antibody prevalence (Results: Between January 2022 and February 2023, 53 sites (community, n=43; prison, n=10) have been established in five states/territories (135 operators trained) with 6,653 HCV point-of-care tests performed (antibody, n=927; RNA, n=5,726) in the community (n=2,021) and prisons (n=4,261). Among those receiving HCV RNA testing, 850 people (14%) have current HCV infection (community, 10%; prison, 15%). HCV treatment uptake is 78% (662 of 850) overall and 93% (595 of 638) in prison. Conclusion: Onsite point-of-care HCV testing has led to high treatment uptake across different settings across Australia. Standardised operator training and quality assurance have been critical for success. Disclosure of Interest Statement: This study has received funding from the Australian Department of Health (LD21/1305), NSW Health, AbbVie, Gilead Sciences, and Cepheid. JG is a consultant/advisor and has received research grants from Abbvie, bioLytical, Camurus, Cepheid, Gilead Sciences, Hologic, and Indivior.

KW - hepatitis C

KW - point-of-care testing

KW - decentralised

KW - national program

UR - https://ashm.eventsair.com/QuickEventWebsitePortal/avhecco-infections-2023/program/Agenda/AgendaItemDetail?id=d36cb56a-98ff-467d-9120-3453319e7a2b

M3 - Abstract

T2 - HIV Coinfection & VH Elimination 2023

Y2 - 21 July 2023 through 22 July 2023

ER -