PROMPt Study

A C (HCV) treatment is the process of conventional testing that requires multiple visits to pathology services and healthcare providers to obtain an HCV antibody (Ab) test, an HCV RNA test, a diagnosis, and then getting linked to appropriate care to commence treatment.

A year ago (see issue 90, at bit. ly/3xFCEp6), we covered the launch of the PROMPt project, which aimed to overcome critical roadblocks to HCV treatment by providing HCV point-of-care (POC) testing and direct linkage into treatment in the priority settings of mental health, prisons and alcohol and other drugs (AOD) services.

PROMPt was run at several sites in SA: the Adelaide Remand Centre, at inpatient alcohol and other drug services, and at a mental health inpatient unit.

Participants were offered an HCV diagnostic test using a quick fingerstick antibody (Ab) assay. Participants who tested HCV-Ab-positive were then offered a fingerstick HCV RNA assay run on the GenXpert machine.

Project staff, including peer educators, provided HCV education, pre- and post-test counselling, and linkage to care at the time of diagnosis.

Participants who tested HCV RNA positive underwent post-test counselling, harm reduction education and were linked to treatment.

Linkage to care consisted of site staff being notified of the positive HCV RNA results, and participant details being sent to the local viral hepatitis nurse for management and treatment.

The study results demonstrate that it is feasible to provide HCV POC testing in the priority settings of mental health, prisons and AOD services. HCV POC testing increased overall rates of HCV testing as compared to the previous 12 months of standard of care testing.

Combined HCV antibody and RNA testing at the point of care has resulted in a significant testing scale-up at each service.

The researchers found high acceptability of POC testing at each service. Working with site staff and local viral hepatitis nurses was extremely effective in facilitating HCV treatment. PROMPt shows that this approach is an excellent way to improve testing rates and ensure people get the treatment and support they need if they are living with hepatitis C .