Engaging The Disengaged: HCV Self Testing and Linkage to Care for Drug Treatment Service Users During COVID

Author: Louise Hansford Yvonne Dawrs Michelle Gallagher Alan Howard Lynda Winn Ben Wilton James Rock

Theme: Models of Care Year: 2022

Self-testing is validated for HIV with evidence for increased uptake, comparable linkage to care and
an absence of harm in at risk individuals. However, there is limited data on this strategy for HCV
infection (WHO 2021).
During COVID, most clinics moved to telephone consultations, reducing opportunities for BBV
screening. This project targeted patients with >12 months follow up for reengagement testing
through supported home self-testing for HCV with rapid linkage to care
Description of model of care/intervention:
Interrogation of patient records identified target populations of older clients (>45years) who had not
previously been tested. Exclusion criteria: previous positive HCV Ab result, prior treatment, negative
DBS test within 6 months. Telephone contact was made to gain consent for participation.
Participants received a postal testing pack including bespoke patient information leaflet and
Oraquick® point of care test. A dedicated phone was used to discuss results and deliver support.
Positive HCV Ab tests triggered urgent assessment by Hepatology nurses supported by Hep C Trust
Preliminary results (full completion May 2022). 210 people participated and received home HCV selftest kits. 92 reported test results (44% of postal tests dispatched). 6 HCV Ab+, 80 HCVAb-, 6 test
failures. 6.5% of completed tests detected HCVAb.
Of the 6 HCVAb+, 5 attended for confirmatory PCR. Two were PCR negative (spontaneous clearance),
two PCR positive patients commenced treatment and one awaits additional diagnostics. The
strength of ODN linkage to care is reflected in the pathway, including two patients who were
subsequently incarcerated and followed up by the prison in reach team.
Conclusion and next steps:
Postal testing for HCV using rapid point of care tests is feasible, providing opportunities to engage
individuals at past or current risk. Once engaged linkage to care was effective, providing useful
avenues for HCV diagnosis and treatment during the pandemic.
Disclosure of Interest Statement:
This project has been supported through an Association of the British Pharmaceutical Industry (ABPI)
‘Joint Working’ initiative between Gilead Sciences Ltd. NHS Addictions Providers Alliance (Hep C U
Later) and NHS England.

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