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

Author: Anna Conway Annabelle Stevens Carolyn Murray Bianca Prain Cherie Power Anna McNulty Nigel Carrington Heng Lu Colette McGrath Phillip Read Mitchell Starr Beth Catlett Colette Philip Cunningham Jason Grebely

Theme: Epidemiology & Public Health Research Year: 2022

Background: Dried blood spot (DBS) testing for HCV RNA provides a client-centred sampling option,
avoiding venepuncture. Large-scale evaluations are needed to understand how DBS testing can
reduce HCV burden. This study estimated prevalence of, and factors associated with, current HCV
infection and treatment initiation among people enrolled in a state-wide pilot.
Methods: The NSW DBS Pilot is an interventional cohort study of people testing for HIV Ab and/or
HCV RNA in New South Wales, Australia. 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 36 community health sites (including drug treatment clinics and
sexual health services) and 21 prisons, with postal delivery to the laboratory. Participants received
results by text (negative) or a healthcare provider (positive). Logistic regression was used to identify
factors associated with current HCV infection and treatment initiation within six months of testing.
Results: Between November 2016 and December 2020, 5,960 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 (878/5,960). Factors associated with current HCV infection included being Aboriginal or Torres
Strait Islander (aOR 1.18, 95%CI 1.01-1.38), and recently injecting drugs (aOR 2.94, 95%CI 2.47-3.50).
Overall, 45% (n=393/878) of people with current HCV initiated treatment within six months (13%
online self-registration, 27% assisted registration in community, 61% assisted registration in prison).
Treatment initiation was associated with testing in prison (vs. online self-registration; aOR 11.31,
95%CI 2.45-52.22), and being male (aOR 1.49, 95%CI 1.04-2.14).
Conclusions: The NSW DBS Pilot demonstrates the feasibility of using DBS to promote HCV testing
and treatment in community and prison settings.
Disclosure of Interest Statement: JG is a consultant/advisor and has received research grants from
AbbVie, Cepheid, Gilead, and Merck outside the submitted work.

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