Insufficient HCV Testing In An Ost Clinic In Stockholm Calls For Changes In Testing Routines

Author: Kåberg M, Makarova N, Weiland O

Theme: Epidemiology & Public Health Research Year: 2017

Background: There is a high prevalence of hepatitis C virus (HCV) in people who inject drugs (PWID) and patients in opiate substitution treatment (OST) in Stockholm. Previous studies have shown a HCV RNA prevalence of 60% indicating an ongoing infection. With continuous injecting risk behaviour, the risk of seroconversion and re-infection is high and repeated HCV testing is thus of great importance in this high prevalence setting.

Methods: This cross-sectional study examined the documented HCV status in all 162 OST patients in a Stockholm OST clinic. Data were collected from patients’ digital chart where all individual HCV testing data from all health care clinics in the Stockholm County are registered and linked to the patient’s unique personal identity number.

Results: Overall, data on HCV testing and result were found in 141/162 (87%) of the OST patients, and 58/162 (36%) participants had a chronic infection (with a repeated HCV-RNA positive tests). Of the remaining 104 participants with either an unknown HCV status or negative for anti-HCV/HCV RNA markers, 32/104 (31%) had an unknown HCV status, 19/104 (18%) were anti-HCV negative, and 53/104 (51%) HCV RNA negative. Only 33/104 (32%) were HCV tested the past twelve months.

Conclusion: These results are of great importance for creating new routines for repeated HCV testing in all OST clinics in Stockholm. With improved testing routines correct diagnosis of HCV will be enhanced and more patients will thus be identified for HCV treatment. Improved testing routines are also a necessity for effective HCV surveillance when HCV treatment is scaled-up in the OST population.