McCartney Erin M, Dawe Joshua, Ralton Lucy, Stewart Jeffrey, Richmond Jacqueline A, Wigg Alan, Cock Victoria, Tse Edmund Y, Rees Tom, Shaw David, Ferguson Catherine
Infectious Diseases Department, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide 5000, Australia.
Bristol Doctoral College, Bristol Medical School, Bristol BS8 2PN, UK.
Viruses. 2024 Dec 4;16(12):1882. doi: 10.3390/v16121882.
Point-of-care hepatitis C virus (HCV) testing streamlines testing and treatment pathways. In this study, we established an HCV model of care in a homelessness service by offering antibody and RNA point-of-care testing.
A nurse and peer-led HCV model of care with peer support were implemented between November 2021 and April 2022 at a homelessness service in Adelaide, Australia. All clients of the service were eligible to participate. Clients were offered an initial antibody point-of-care test, and antibody positive clients were immediately offered RNA point-of-care testing. Clients who tested RNA positive were linked to a viral hepatitis nurse for treatment.
A total of 230 clients received an HCV antibody point-of-care test, of which 68 (30%) were antibody positive and 11 (5%) were RNA positive. Of these, seven (64%) clients successfully completed treatment and five (45%) received a sustained virological response (SVR) test to confirm cure.
We successfully established HCV testing and a treatment pathway at a homelessness service using HCV antibody and RNA point-of-care testing. The high testing uptake underscores the utility of HCV point-of-care testing when establishing HCV testing and treatment pathways. The low RNA positivity suggests that an initial HCV antibody test was cost-effective, and the four clients diagnosed with chronic HCV who were lost to follow-up indicate a need for enhanced treatment support.
即时检测丙型肝炎病毒（HCV）可简化检测和治疗流程。在本研究中，我们通过提供抗体和RNA即时检测，在一家无家可归者服务机构建立了HCV照护模式。
2021年11月至2022年4月期间，在澳大利亚阿德莱德的一家无家可归者服务机构实施了由护士和同伴主导并提供同伴支持的HCV照护模式。该服务机构的所有客户均有资格参与。为客户提供了初始抗体即时检测，抗体呈阳性的客户立即接受RNA即时检测。RNA检测呈阳性的客户与一名病毒性肝炎护士联系以接受治疗。
共有230名客户接受了HCV抗体即时检测，其中68名（30%）抗体呈阳性，11名（5%）RNA呈阳性。其中，7名（64%）客户成功完成治疗，5名（45%）接受了持续病毒学应答（SVR）检测以确认治愈。
我们通过使用HCV抗体和RNA即时检测，在一家无家可归者服务机构成功建立了HCV检测及治疗流程。高检测接受率凸显了HCV即时检测在建立HCV检测和治疗流程时的效用。低RNA阳性率表明初始HCV抗体检测具有成本效益，4名被诊断为慢性HCV但失访的客户表明需要加强治疗支持。
