Abstract
BackgroundBetween December 2018 and January of 2019, we evaluated the accuracy of the point-of-care Hepatitis C (HCV) antibody test (POC; OraQuick HCV) used at a community-based needle and syringe exchange program serving persons who inject drugs in Tallinn, Estonia.MethodsWe compared the results of screening for HCV antibodies by OraQuick (oral swab) and enzyme immunoassay (EIA; blood draw) and assessed test results implications in a high prevalence setting.FindingsOf the 100 participants, 88 (88%) had reactive POC test results, and 93 were HCV antibody positive on EIA testing. Sensitivity, specificity and negative predictive value (NPV) for the POC assay with EIA as the relevant reference test were as follows: 94.6% (95% CI 90.0–99.2%), 100% and 58.3% (95% CI 30.4–86.2%). Of the 12 testing, HCV-negative with the POC only 7 (58.3%) were true negatives.ConclusionsOral swab rapid testing HCV screening in this nonclinical setting was sensitive and specific but had unacceptably low NPV. In high prevalence settings, POC tests with high sensitivity and that directly measure HCV RNA may be warranted.
Highlights
Oral swab rapid testing hepatitis C virus (HCV) screening in this nonclinical setting was sensitive and specific but had unacceptably low negative predictive value (NPV)
POC tests with high sensitivity and that directly measure HCV RNA may be warranted
Drug use is central to sustaining hepatitis C virus (HCV) incidence in developed countries, with exposure to contaminated injection equipment among people who inject drugs (PWID) making them vulnerable [1]
Summary
Drug use is central to sustaining hepatitis C virus (HCV) incidence in developed countries, with exposure to contaminated injection equipment among people who inject drugs (PWID) making them vulnerable [1]. Communitybased testing, together with implementation of novel testing approaches in several settings, including drug services has been effective in reaching populations at higher risk for infection and hard‐to‐reach populations [5]. The use of point-of-care (POC) tests to detect HCV antibodies has been implemented in a variety of settings in the USA and Australia, mostly at sites with HCV antibodies seropositivity < 30% (correctional centers [9], community-based settings (including needle and syringe exchange programs [10], urban STI clinics [11]) but not always (NSPs [12]). Between December 2018 and January of 2019, we evaluated the accuracy of the point-of-care Hepatitis C (HCV) antibody test (POC; OraQuick HCV) used at a community-based needle and syringe exchange program serving persons who inject drugs in Tallinn, Estonia
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