Hep C point-of-care test helps marginalised populations

There are 74,000 people living with hepatitis C in Australia, most of whom are unaware that they have it. Marginalised population groups (such as people who inject drugs and people who are incarcerated) are among those at particular risk of hepatitis C and are groups that are often neglected by traditional health services. Further, while hepatitis C treatments are effective, challenges arise in the case of people not adequately engaged with the health system, including remotely located population groups. A program using diagnostic technologies at the ‘point of care’ could hold the answer.

UNSW Sydney’s Kirby Institute together with Flinders University International Centre for Point-of-Care Testing have been funded by the Australian Government Department of Health to establish a National Australian Hepatitis C Point-of-Care Testing Program, designed to engage across all priority populations highlighted in hepatitis strategies, including people who inject drugs and/or are accessing drug treatment programs, people who previously injected drugs, people in custodial settings and Aboriginal and Torres Strait Islander people. (Continuation and expansion funding has also been provided for another Kirby Institute-led program, the First Nations Molecular Point-Of-Care Testing Program, led by Professor Rebecca Guy.)

As Professor Jason Grebely — National Australian Hepatitis C Point-of-Care Testing Program lead — explains, those not adequately engaged with the health system benefit from point-of-care testing “because it allows us to bring the lab to the places where people who are at-risk already are, such as drug treatment clinics, needle and syringe programs, community health centres, prisons and community-led organisations”. Grebely adds that the program “is designed to scale-up point-of-care hepatitis C testing to get these people onto curative treatment and ultimately eliminate hepatitis C in Australia”.

A point-of-care test is performed at a clinic in Cairns. ©Conor Ashleigh

Close to 40,000 tests have been performed, 3613 people have been diagnosed with hepatitis C, and 2557 people have initiated treatment in the first phase of this program, with additional funding now facilitating the expansion of the program to 110 sites (at more than 400 testing locations) across Australia. This will result in approximately 100,000 tests by 2026. This includes diverse locations such as Aboriginal Community Controlled Health Organisations, drug treatment clinics, homelessness services, mobile outreach clinics, mental health facilities and prisons.

“Before, test results could take weeks to be returned to patients, at which point they may no longer be engaged in the health system,” Grebely said. “Using this highly accurate testing technology, we can test for an infection or infections, interpret the results and, if needed, initiate treatment, all within one visit. This is a game changer when working with marginalised or remotely located population groups. It simplifies the pathway to treatment, and interrupts transmission by getting people onto treatment quicker.”

Top image caption: Point-of-care testing in these Kirby Institute-led programs involves collecting either a finger stick blood specimen, a swab from the oral or genital area, or in this case a urine test — and placing it into a GeneXpert cartridge for testing in the machine, which takes around an hour to process the specimen and deliver a result. Image: Kirby Institute