Hepatitis C Treatment Uptake Following Dried Blood Spot Testing for Hepatitis C RNA in New South Wales, Australia: The NSW DBS Pilot Study

Abstract

Background Dried blood spot (DBS) testing for HCV RNA provides a sampling option which avoids venepuncture and can be carried out in a non-clinical setting. Large-scale evaluations are needed to understand how DBS testing can reduce HCV burden. This study estimated prevalence of, and factors associated with, HCV RNA and treatment initiation among people enrolled in a state-wide pilot of people testing in the NSW DBS Pilot in New South Wales, Australia. Methods People at risk of HIV/HCV could participate via: 1) self-registration online with a DBS collection kit delivered and returned by conventional postal service; or 2) assisted DBS sample collection at community sites or prison. Logistic regression was used to identify factors associated with detectable HCV RNA and treatment initiation within six months of testing. Results Between September 2017 and December 2020, 5960 people tested for HCV (76% men, 35% Aboriginal and/or Torres Strait Islander, 55% recently injected drugs); 21% online self-registration, 34% assisted registration in community, 45% assisted registration in prison. 15% had detectable HCV RNA (878/5960). Overall, 44% (n = 386/878) of people with current HCV initiated treatment within six months (13% online self-registration, 27% assisted registration in community, 61% assisted registration in prison). Testing in prison compared to community (aOR 4.28, 95% CI 3.04-6.03) was associated with increased odds of treatment initiation. Being a woman compared to man (aOR 0.68, 95% CI 0.47-0.97) was associated with reduced treatment initiation. Conclusions The NSW DBS Pilot demonstrates the feasibility of using DBS to promote HCV testing and treatment in community and prison settings.

Testing, diagnosis, and treatment following the implementation of a program to provide dried blood spot testing for HIV and hepatitis C infections: the NSW DBS Pilot

“…The study methods have been described previously [ 23 ]. For online registration, participants accessed a public website ( https://dbstest.health.nsw.gov.au/ ) to assess eligibility, received a collection kit, and delivered a sample by return paid envelope to be tested at the St Vincent’s Centre for Applied Medical Research Centre, NSW State Reference Laboratory for HIV, St Vincent’s Hospital, Sydney.…”