Chiew Brandon A, Fong Anita Yp, Cosgrove Linh T, Mohajerani Seyed Amir, Ramji Alnoor, Lee Samuel S
Liver Unit, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
London Drugs, 12831 Horseshoe Place, Richmond, British Columbia, Canada.
Can Liver J. 2023 Dec 20;6(4):388-394. doi: 10.3138/canlivj-2023-0005. eCollection 2023 Dec.
The estimated prevalence of hepatitis C virus (HCV) in Canada is approximately 1.0%. However, the number of individuals living with HCV but unaware of it is estimated to be 30%-44%. Increased screening programs that are accessible, effective, and feasible are important to ensure treatment and meet WHO elimination goals. We implemented an HCV point of care test (POCT) program in community pharmacies to examine the effectiveness and feasibility in screening.
Twenty two London Drugs pharmacies in British Columbia and Alberta implemented an HCV POC screening program using OraQuick rapid antibody tests. Consenting patients filled out a 10-question screening questionnaire to examine risk factors. The participants then were tested using the POCT. While waiting for the test (20 minutes), patients were educated on HCV and treatment options.
Three hundred seventy-one participants underwent HCV screening. The most common HCV risk factor was being born between 1945 and 1975 (baby boomer) (93% of cohort), while the second most common was having a tattoo or body piercing (22%). Seven people (2%) tested positive; four were HCV-RNA PCR-positive and were treated, whereas the PCR status of three was unknown as they were lost to follow-up or not tested.
Pharmacy-based POCT was shown to be effective and feasible in the western Canadian context, especially for baby boomers. Sustainable funding for pharmacy screening programs may be considered nationwide to identify HCV-infected persons and help meet elimination goals.
加拿大丙型肝炎病毒(HCV)的估计患病率约为1.0%。然而,估计有30%-44%的HCV感染者并不知道自己感染。增加可及、有效且可行的筛查项目对于确保治疗和实现世界卫生组织的消除目标至关重要。我们在社区药房实施了一项HCV即时检验(POCT)项目,以检验筛查的有效性和可行性。
不列颠哥伦比亚省和艾伯塔省的22家伦敦药店实施了一项使用奥奎克快速抗体检测的HCV即时检验筛查项目。同意参与的患者填写一份包含10个问题的筛查问卷,以检查风险因素。然后使用即时检验对参与者进行检测。在等待检测结果(20分钟)期间,对患者进行HCV及治疗选择方面的教育。
371名参与者接受了HCV筛查。最常见的HCV风险因素是出生于1945年至1975年之间(婴儿潮一代)(占队列的93%),第二常见的是有纹身或穿孔(22%)。7人(2%)检测呈阳性;4人HCV-RNA PCR检测呈阳性并接受了治疗,而另外3人的PCR检测结果未知,因为他们失访或未进行检测。
在加拿大西部的背景下,基于药房的即时检验被证明是有效且可行的,尤其是对婴儿潮一代。可考虑在全国范围内为药房筛查项目提供可持续资金,以识别HCV感染者并帮助实现消除目标。