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      Acceptability of Rapid Point-of-Care Hepatitis C Tests Among People Who Inject Drugs and Utilize Syringe-Exchange Programs

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          Abstract

          People who inject drugs may benefit from point-of-care hepatitis C virus (HCV) testing offered at syringe exchanges. We sought to understand whether this population would be willing to undergo rapid HCV testing. We found that there was broad support for rapid HCV testing, especially among younger people who inject drugs with high perceived risk.

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          Cost-effectiveness of rapid hepatitis C virus (HCV) testing and simultaneous rapid HCV and HIV testing in substance abuse treatment programs.

          To evaluate the cost-effectiveness of rapid hepatitis C virus (HCV) and simultaneous HCV/HIV antibody testing in substance abuse treatment programs.
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            A pilot study of rapid hepatitis C virus testing in the Rhode Island Department of Corrections

            The correctional population bears a heavy burden of hepatitis C virus (HCV) infection necessitating expansion of HCV testing and treatment opportunities. Rapid HCV testing provides point-of-care antibody results and may be ideal for correctional facilities, particularly jails, where persons are often incarcerated for short periods of time, yet feasibility has not been established.
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              Cost-effectiveness of strategies for testing current hepatitis C virus infection

              Six strategies for identifying hepatitis C virus (HCV) viremia, involving testing for HCV antibody (HCVAb) followed by a nucleic acid test (NAT) for HCV RNA when the antibody test is positive, are compared. Decision analysis was used to determine mean relative cost per person tested and outcomes of HCV viremia detection. Parameters included proportions of test population with HCVAb and viremia plus specificity, sensitivity, and cost of individual tests. For testing a population with an HCVAb seroprevalence of 3.25%, all strategies when adopting quantitative NAT vary little in cost (range, $29.50-$30.70) and are highly viremia specific (≥0.9997). Four of the strategies using venipuncture blood for HCVAb testing (whether laboratory conducted or employing a rapid, point-of-care assay) and for NAT (whether done by reflex or using separately drawn blood) achieve the highest viremia sensitivities (range, 0.9950-0.9954). Point-of-care HCVAb testing in fingerstick blood followed by NAT in venipuncture blood yields relatively lower viremia sensitivity (0.9301). The strategy that requires returning for NAT is even less viremia sensitive (<0.9000) because of follow-up loss. Strategies adopting qualitative rather than quantitative NAT are slightly cheaper (range, $28.90-$29.99), similarly viremia specific (≥0.9997), but less viremia sensitive (≤0.9456). Viremia sensitivity and specificity remain the same regardless of the proportion of HCVAb-seropositive persons in the cohort being tested.
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                Author and article information

                Journal
                Open Forum Infect Dis
                Open Forum Infect Dis
                ofid
                ofids
                Open Forum Infectious Diseases
                Oxford University Press
                2328-8957
                March 2016
                06 April 2016
                : 3
                : 2
                Affiliations
                [1 ]Division of Infectious Disease, Massachusetts General Hospital , Boston
                [2 ]Division of Infectious Disease, HIV Epidemiology and Outcomes Research Unit, Boston University Medical Center , Massachusetts
                [3 ]Division of Infectious Disease, Medical College of Wisconsin , Milwaukee
                [4 ]Departments of Medicine
                [5 ]Population Health Sciences, University of Wisconsin School of Medicine and Public Health , Madison
                Author notes
                Correspondence: J. A. Barocas, Division of Infectious Disease, Massachusetts General Hospital, 55 Fruit St., GrJ-504, Boston, MA 02114 ( jbarocas@ 123456mgh.harvard.edu ).
                Article
                ofw075
                10.1093/ofid/ofw075
                4867657
                27191007
                50b7a3a3-493e-462f-8b07-2612a6cd8e45
                © The Author 2016. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com.

                Page count
                Pages: 3
                Product
                Funding
                Funded by: Clinical and Translational Science Award
                Funded by: NIH
                Funded by: National Center for Advancing Translational Sciences http://dx.doi.org/10.13039/100006108
                Award ID: UL1TR000427
                Funded by: NIH
                Award ID: K23DA032306
                Categories
                Brief Reports
                Custom metadata
                Spring 2016

                hepatitis c screening,people who inject drugs,rapid diagnostics,syringe exchange programs

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