Hepatitis C antibody testing among opioid agonist therapy recipients, Victoria, Australia, 2012 to 2020

Joshua Dawe; Anna L Wilkinson; Jason Asselin; Allison Carter; Alisa Pedrana; Michael W Traeger; Alexander J Thomas; Michael Curtis; Monica Cooper; Jessica Howell; Joseph S Doyle; Margaret E Hellard; Mark Stoové; EC Victoria Partnership and the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of blood borne viruses and sexually transmissible infections (ACCESS)

doi:10.1016/j.drugpo.2022.103696

Hepatitis C antibody testing among opioid agonist therapy recipients, Victoria, Australia, 2012 to 2020

Int J Drug Policy. 2022 Jun:104:103696. doi: 10.1016/j.drugpo.2022.103696. Epub 2022 Apr 28.

Authors

Joshua Dawe¹, Anna L Wilkinson², Jason Asselin³, Allison Carter⁴, Alisa Pedrana², Michael W Traeger², Alexander J Thomas³, Michael Curtis⁵, Monica Cooper⁶, Jessica Howell⁷, Joseph S Doyle⁸, Margaret E Hellard⁹, Mark Stoové²; EC Victoria Partnership and the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance of blood borne viruses and sexually transmissible infections (ACCESS)

Affiliations

¹ Burnet Institute, Melbourne, Australia. Electronic address: joshua.dawe@burnet.edu.au.
² Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Burnet Institute, Melbourne, Australia.
⁴ Kirby Institute, UNSW Sydney, Sydney, Australia; Faculty of Health Sciences, Simon Fraser University, British Columbia, Canada.
⁵ Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Monash Addiction Research Centre, Monash University, Melbourne, Australia.
⁶ Lygon Court Medical Clinic, Melbourne, Australia.
⁷ Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia.
⁸ Burnet Institute, Melbourne, Australia; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia.
⁹ Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Australia; Doherty Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.

PMID: 35490624
DOI: 10.1016/j.drugpo.2022.103696

Abstract

Background: The high burden of hepatitis C among people who inject drugs in Australia underscores the need to increase testing within this population. Understanding hepatitis C screening uptake in primary care settings is therefore critical to the development of effective and targeted strategies to improve hepatitis C testing for people who inject drugs. Primary care services that prescribe OAT are well-positioned to provide hepatitis C testing among a priority population at-risk of hepatitis C.

Methods: This study used linked data from 5,429 individuals attending ten clinical services participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) who received their first recorded OAT prescription between 1^st January 2012 and 31^st December 2019. We estimated the proportion of OAT recipients who received a hepatitis C antibody test within 12 months of their first recorded OAT prescription, and the proportion of individuals tested who received a positive hepatitis C antibody test.

Results: Approximately one in five individuals (17%) received a hepatitis C antibody test in the 12 months following their first recorded OAT prescription. Over half of individuals tested (56%) received a positive hepatitis C antibody test result. Hepatitis C antibody testing was higher among individuals who attended 5-8 (aOR:2.98; 95%CI:2.41-3.69) and 9+ (aOR:6.17; 95%CI:5.13-7.43) clinical consultations, were women (aOR:1.20; 95%CI:1.08-1.34) and whose first recorded OAT prescription occurred in 2017 vs. 2012 (aOR:1.39; 95%CI:1.06-1.84). Hepatitis C antibody testing was lower among individuals prescribed methadone (aOR:0.81; 95%CI:0.73-0.91), and individuals aged 60+ years vs. 18-29 years (aOR:0.67; 95%CI:0.48-0.94).

Conclusion: Despite high positivity rates, hepatitis C antibody testing among individuals prescribed OAT remains low. There are opportunities for increased testing among populations exhibiting greater proportions of missed testing opportunities. Integrating routine hepatitis C screening in OAT settings will likely increase case-finding and contribute to Australia's hepatitis C elimination targets.

Keywords: Australia; HCV screening; Hepatitis C; Opioid agonist therapy; People who inject drugs; Primary care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Analgesics, Opioid / therapeutic use
Antiviral Agents / therapeutic use
Female
Hepacivirus
Hepatitis C Antibodies
Hepatitis C* / diagnosis
Hepatitis C* / drug therapy
Hepatitis C* / epidemiology
Humans
Male
Substance Abuse, Intravenous* / complications
Substance Abuse, Intravenous* / drug therapy
Substance Abuse, Intravenous* / epidemiology
Victoria

Substances

Analgesics, Opioid
Antiviral Agents
Hepatitis C Antibodies