Theme: Epidemiology and Public Health Research Year: 2021
Background: Individuals who currently or have ever injected drugs are at risk of hepatitis C virus (HCV) infection. Protocols developed by drug treatment services (DTS) allow at-risk individuals to be tested and linked to appropriate care. This analysis assessed the impact of the COVID-19 pandemic on HCV testing in DTS in England. Method: The number of HCV tests performed, and proportion testing positive for HCV antibody and PCR, across six DTS providers in England were recorded. Statistical analyses were performed using PRISM9. Data were averaged per quarter and compared across three distinct phases of the COVID-19 pandemic: 1. Baseline (pre-pandemic): Sept2019-Feb2020; 2. National lockdown: Mar-May2020; 3. Recovery: Jun2020-Feb2021. Results: Between Sept2019-Feb21; 32,250 individuals were tested for HCV. Where data were available, 69% were male (n=22,342), 19% current injectors (n=4,922) and 31% previous injectors (n=7,982). There were significantly fewer tests conducted during the periods of National lockdown and Recovery, versus Baseline (p=0.03 and 0.018, respectively). Postal testing was introduced by some services in Sept2020. Where data are available, they accounted for 15% (n=644) of tests conducted Sept20-Nov20 and 20% (n=863) Dec20- Feb21. During the Recovery period there were a higher number of clients testing positive for HCV antibody and PCR versus Baseline; 30% vs 20% (p=0.002) and 13% vs 8.5% (p=0.0062), respectively. This may, in part, be explained by a higher proportion of Current Injectors tested between Sept20-Feb21 versus Baseline; 22.5% versus 18.5% (p=0.01). There were, however, no statistically significant differences in age, gender or injecting status. Conclusion: Restrictions introduced in England to control the COVID-19 pandemic significantly impacted the number of HCV tests performed. Adaptation of pathways, including postal and outreach testing, have increased the proportion of service users accessing tests, particularly Current Injectors. Continued adaptations will further limit the impact of further restrictions, such as those imposed between Jan-Apr21. Figure:
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