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Hepatitis C Screening in Community-Based Voluntary Counselling and Testing Services in Europe: An Observational Study
Anna Conway1,2, Laura Fernàndez-López3,4,5, Juliana Reyes-Urueña3,4
1Generalitat de Catalunya Departament de Salut, Centre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Catalunya, Spain. aconway@igtp.cat.
Insights
Community-based voluntary counselling and testing (CBVCT) services screened over 7,000 individuals for Hepatitis C virus (HCV). Reactive screening tests were linked to HIV-positive men who have sex with men (MSM) and people who inject drugs (PWID).
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- The COBATEST Network facilitates community-based voluntary counselling and testing (CBVCT) for Hepatitis C virus (HCV) across Europe.
- Standardized data collection tools are employed to monitor HCV testing trends and outcomes within the network.
Purpose of the Study:
- To characterize the demographic profile of individuals undergoing HCV screening within the COBATEST Network.
- To identify specific risk factors associated with reactive anti-HCV antibody test results between 2014 and 2018.
Main Methods:
- Analysis of data from 7,426 clients screened for HCV antibodies across 22 centers in 10 European countries from 2014-2018.
- Inclusion criteria: clients aged over 16 years accessing CBVCT services for HCV screening.
Main Results:
- A total of 113 (1.5%) individuals tested positive for anti-HCV antibodies.
- The majority of screened individuals were aged 25-44, men who have sex with men (MSM), and not HIV-positive, injecting drug users, or sex workers.
- Reactive screening was significantly associated with being HIV-positive MSM (aOR 9.1) and being a person who injects drugs (PWID) (aOR 28.1).
Conclusions:
- HIV-positive MSM without a history of injection drug use are utilizing CBVCT services for HCV screening.
- Reactive HCV screening results are strongly correlated with HIV-positive status and a history of injecting drug use.
- Integrating HCV screening into CBVCT services can improve testing accessibility for at-risk populations.
Abstract:
The COBATEST Network links community-based voluntary counselling and testing (CBVCT) services in the European region and collects testing data using standardised data collection tools. This study aims to describe the population being screened for anti-HCV antibodies in the COBATEST Network and identify risk factors associated with a reactive HCV screening test result in the period 2014-2018. Clients aged > 16 screened for HCV in the period 2014-2018 at one of the Network's CBVCT services were included in the study. In the 5 year period, 7426 clients were screened for HCV in 22 centres in 10 countries and anti-HCV antibodies were detected in 113 (1.5%). The majority of people screened were aged 25-44, men who have sex with men (MSM), not HIV+ , not reporting a history of injecting drug use or sex work. Detection of anti-HCV antibodies was associated with being HIV + MSM (aOR 9.1, 95% CI 3.8; 21.8 compared to HIV-clients) and being a person who injects drugs (PWID, aOR 28.1, 95% CI 17.6; 45.0, compared to people with no history of injecting drug use). This study demonstrates that HIV-MSM with no history of injection drug use are using CBVCT services for HCV screening, but reactive screening test is associated with being HIV+ or PWID. The integration of HCV screening into the CBVCT service model may widen access to testing for populations that may otherwise not be tested.
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