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P68 Is it worth testing unstable drug users for hepatitis C?
  1. B P Stephens
  1. Ninewells Hospital, Dundee

Abstract

Introduction Within the UK the main source of hepatitis C virus (HCV) infection is injecting drug use however, diagnosing HCV in chaotic drug users has often proved challenging, particularly if venous access is a problem.

Aim To evaluate the introduction of HCV dry blood spot testing (DBST) by staff working in addiction services and to determine if individuals who agreed to testing, returned for their results and accessed appropriate follow-up into either drug or HCV treatment.

Method The study was carried out over an 18-month period between 2009 and 2010. Testing for HCV was offered to individuals who accessed addiction services during this period. A follow-up appointment was issued for 2 weeks after testing. The numbers tested were monitored and data were collected on follow-up appointments attended.

Results During the study, 661 tests were carried out using the DBST method. 479 (72.5%) within needle exchange services and 182 (27.5%) from drug treatment services. 439 (66%) were male, and the age range was 18 to 51 years with a median age of 32 years. 608 (91.3%) individuals returned for the results of their test and 186 (28%) of the 661 tests were HCV antibody positive. Follow-up bloods were offered to all positive patients. Of the 147 (79%) who had blood taken 90 (61.1%) were HCV PCR positive. HCV PCR negative individuals were provided with harm reduction advice, were encouraged to access drug treatment, and discharged from further HCV follow-up. All PCR positive individuals were offered referral onto drug treatment and/or specialist HCV services for assessment and treatment. Abstract P68 table 1 lists summary of outcomes.

Abstract P68 Table 1

Engagement of HCV PCR positive individuals

Conclusion The study has shown DBST is easy to use and can be carried out without difficulty by staff within drug services. The offer of HCV testing was well received by this particular client group with over 90% of individuals returning for their results. The study has shown that DBST in practice significantly increased the number of new diagnosis within our region by 77% from 245 in 2007–2008 to 435 in 2009–2010. DBST led a significant number of people into drug and HCV treatment services and therefore proves that diagnosing hepatitis C can have life improving benefits for people.

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