Georgina McAllister1, Hamish Innes2, Allan Mcleod3, John F Dillon4, Peter C Hayes5, Ray Fox6, Stephen T Barclay7, Kate Templeton8, Celia Aitken9, Rory Gunson9, David Goldberg10, Sharon J Hutchinson2. 1. East of Scotland Specialist Virology Centre, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Scotland, UK. Electronic address: g.mcallister@nhs.net. 2. Glasgow Caledonian University, Cowcaddens Rd, Glasgow, Lanarkshire, Scotland, UK; Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland, UK. 3. Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland, UK. 4. NHS Tayside, Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland, UK. 5. Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, Scotland, UK. 6. Department of Infectious Diseases, Gartnavel General Hospital, Glasgow, UK. 7. Glasgow Royal Infirmary, Glasgow, Scotland, UK. 8. East of Scotland Specialist Virology Centre, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Scotland, UK. 9. West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, Scotland, UK. 10. Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland, UK; Glasgow Caledonian University, Cowcaddens Rd, Glasgow, Lanarkshire, Scotland, UK.
Abstract
BACKGROUND: Dried blood spot (DBS) testing for hepatitis C (HCV) was introduced to Scotland in 2009. This minimally invasive specimen provides an alternative to venipuncture and can overcome barriers to testing in people who inject drugs (PWID). OBJECTIVES: The objective of this study was to determine rates and predictors of: exposure to HCV, attendance at specialist clinics and anti-viral treatment initiation among the DBS tested population in Scotland. STUDY DESIGN: DBS testing records were deterministically linked to the Scottish HCV Clinical database prior to logistic regression analysis. RESULTS: In the first two years of usage in Scotland, 1322 individuals were tested by DBS of which 476 were found to have an active HCV infection. Linkage analysis showed that 32% had attended a specialist clinic within 12 months of their specimen collection date and 18% had begun anti-viral therapy within 18 months of their specimen collection date. A significantly reduced likelihood of attendance at a specialist clinic was evident amongst younger individuals (<35 years), those of unknown ethnic origin and those not reporting injecting drug use as a risk factor. CONCLUSION: We conclude that DBS testing in non-clinical settings has the potential to increase diagnosis and, with sufficient support, treatment of HCV infection among PWID.
BACKGROUND: Dried blood spot (DBS) testing for hepatitis C (HCV) was introduced to Scotland in 2009. This minimally invasive specimen provides an alternative to venipuncture and can overcome barriers to testing in people who inject drugs (PWID). OBJECTIVES: The objective of this study was to determine rates and predictors of: exposure to HCV, attendance at specialist clinics and anti-viral treatment initiation among the DBS tested population in Scotland. STUDY DESIGN:DBS testing records were deterministically linked to the Scottish HCV Clinical database prior to logistic regression analysis. RESULTS: In the first two years of usage in Scotland, 1322 individuals were tested by DBS of which 476 were found to have an active HCV infection. Linkage analysis showed that 32% had attended a specialist clinic within 12 months of their specimen collection date and 18% had begun anti-viral therapy within 18 months of their specimen collection date. A significantly reduced likelihood of attendance at a specialist clinic was evident amongst younger individuals (<35 years), those of unknown ethnic origin and those not reporting injecting drug use as a risk factor. CONCLUSION: We conclude that DBS testing in non-clinical settings has the potential to increase diagnosis and, with sufficient support, treatment of HCV infection among PWID.
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