Evaluation of the Xpert fingerstick HCV viral load assay

Lamoury, F.; Bajis, Sahar; Hajarizadeh, Behzad; Marshall, A.; Martinello, Marianne; Иванова, Е. С.; Catlett, Beth; Mowat, Yasmin; Marks, Philippa; Amin, Janaki; Smith, Joseph E.; Ezard, Nadine; Cock, Victoria; Hayllar, Jeremy; Persing, David H.; Kleman, Marika; Cunningham, Philip; Dore, Greg; Applegate, Tanya; Grebely, Jason

doi:10.1016/s0168-8278(18)30546-4

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“…HCV infection was determined by HCV RNA quantification using the Xpert ® HCV Viral Load Fingerstick Assay, performed on fingerstick whole-blood samples. 23,24 Prior to the availability of the Xpert ® HCV Viral Load Fingerstick Assay on 14 Jan 2016, HCV RNA testing was completed using a validated in-house qualitative polymerase chain reaction assay, performed on dried blood spots collected by fingerstick whole-blood samples. 25…”

Section: Study Outcomesmentioning

confidence: 99%

“…Although the project incorporated point-of-care HCV RNA testing, due to a lack of regulatory approval these results were not made available to participants. The development of well-tolerated, pangenotypic DAA regimens and the recent licensing of point-of-care HCV RNA testing technology23,48 provides the opportunity to enhance linkage to treatment. Studies will shortly commence to evaluate rapid HCV RNA screening and sameday DAA initiation among PWID attending needle and syringe programs and among inmates of a remand prison setting.…”

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confidence: 99%

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Hepatitis C virus testing, liver disease assessment and treatment uptake among people who inject drugs pre‐ and post‐universal access to direct‐acting antiviral treatment in Australia: The LiveRLife study

Bajis

Grebely

Hajarizadeh

et al. 2019

Journal of Viral Hepatitis

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Gaps in hepatitis C virus (HCV) testing, diagnosis, liver disease assessment and treatment uptake among people who inject drugs (PWID) persist. We aimed to describe the cascade of HCV care among PWID in Australia, prior to and following unrestricted access to direct‐acting antiviral (DAA) treatment. Participants enrolled in an observational cohort study between 2014 and 2018 provided fingerstick whole‐blood samples for dried blood spot, Xpert HCV Viral Load and venepuncture samples. Participants underwent transient elastography and clinical assessment by a nurse or general practitioner. Among 839 participants (mean age 43 years), 66% were male (n = 550), 64% (n = 537) injected drugs in the previous month, and 67% (n = 560) reported currently receiving opioid substitution therapy. Overall, 45% (n = 380) had detectable HCV RNA, of whom 23% (n = 86) received HCV treatment within 12 months of enrolment. HCV treatment uptake increased from 2% in the pre‐DAA era to 38% in the DAA era. Significant liver fibrosis (F2‐F4) was more common in participants with HCV infection (38%) than those without (19%). Age 50 years or older (aOR, 2.88; 95% CI, 1.18‐7.04) and attending a clinical follow‐up with nurse (aOR, 3.19; 95% CI, 1.61‐6.32) or physician (aOR, 11.83; 95% CI, 4.89‐28.59) were associated with HCV treatment uptake. Recent injection drug use and unstable housing were not associated with HCV treatment uptake. HCV treatment uptake among PWID has increased markedly in the DAA era. Evaluation of innovative and simplified models of care is required to further enhance treatment uptake.

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Section: Study Outcomesmentioning

confidence: 99%

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confidence: 99%