Hepatitis C testing in general practice settings: A cross-sectional study of people who inject drugs in Australia

People who inject drugs (PWID) often do not receive confirmatory RNA testing following positive HCV antibody testing. Expanding access to adequate testing and assessment will improve the progression of patients through the HCV care cascade with the potential to improve diagnosis as well as linkage to treatment. We aimed to determine current utilisation of general practitioners (GPs) by PWID in Australia compared to other settings for HCV testing and post-test discussions.

A national sample (n=888) of people who had injected drugs regularly in the past 6 months was interviewed about HCV antibody, RNA testing, and post-test discussions, and the settings where these took place.

The majority of participants (n=735; 93%) reported antibody testing. Among participants who reported a positive result (n=435), 54% identified their regular GP as the setting where their most recent antibody test was conducted. Confirmatory RNA testing was reported by 60% (n=274) of those who reported being antibody positive. Among those who reported RNA testing (n=257), the most common setting reported was their regular GP (48%). There were no differences in the proportions who recalled post-test discussions at GPs compared to other settings.

HCV testing was most frequently undertaken by participants' regular GP. GPs are currently providing testing and post-test discussions at similar proportions to other more specialised settings. However, RNA testing is incomplete for more than one-third of the antibody positive PWID interviewed. Our findings suggest that the general practice setting is a common and accessible setting for PWID to access HCV testing. Targeting GPs to improve follow-up of positive antibody tests may help to improve patient progression through the HCV care cascade.