IMPLEMENTATION OF A TEST AND TREAT MODEL FOR HCV CARE UTILIZING POINT OF CARE HCV RNA TESTING IN LA BODEGA

Abstract

Introduction and Objectives

The World Health Organization (WHO) aims to eliminate hepatitis C virus (HCV) by 2030; however, the United States (US) is unlikely to meet this target. Screening, linkage, and treatment initiation remain suboptimal.

To evaluate Point-of-care (POC) HCV RNA test (Xpert® HCV) in a test and treat model of care among People Who Use Drugs (PWUD).

Materials and Methods

La Bodega, a co-localized hepatology and addiction medicine program in Buffalo, New York (NY), specializes in HCV management among active PWUD. POC HCV RNA testing is utilized on-site. Patients with a positive HCV RNA initiate HCV therapy at the time of the initial visit. POC HCV RNA testing is also used in conjunction with lab-based RNA testing on serum to evaluate SVR4 when indicated.

Results

65 people were screened with POC HCV RNA of whom 40 had a previous HCV antibody. 11 individuals were found to be HCV RNA positive. Eleven individuals were assessed for SVR, all of whom had both undetectable serum HCV RNA and negative POC HCV RNA results. Among RNA-positive individuals, one was linked to their primary care clinic based on the patient’s preference and 10 individuals initiated therapy, receiving the full 8 or 12 weeks of therapy, depending on the chosen regimen. Two individuals remain on treatment; 6 are pending SVR assessment, and 2 achieved SVR, one of whom was pregnant and treated with sofosbuvir/velpatasvir.

Conclusions

POC HCV RNA testing is advantageous in shortening the HCV care cascade, enabling a true test-and-treat model of care for HCV.