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Successful Implementation of Hepatitis C Virus Point-of-Care Testing in a Syringe Services Program.
Sara N Glick1,2, Susan Kingston1, Kristen Wilson-Weiberg2
1School of Medicine, University of Washington, Seattle, WA, USA.
Substance Use & Addiction Journal
|July 12, 2026
Summary
Point-of-care (POC) hepatitis C virus (HCV) RNA testing in syringe services programs (SSPs) successfully identified cases. However, linkage to HCV treatment initiation remained low, suggesting a need for enhanced support.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Health Services Research
Background:
- Syringe services programs (SSPs) are crucial for people who use drugs (PWUD), offering essential services including hepatitis C virus (HCV) testing and treatment linkage.
- Traditional laboratory-based HCV RNA testing can be a significant barrier to timely diagnosis and care initiation for PWUD within SSPs.
- Implementing point-of-care (POC) HCV RNA testing aims to streamline the diagnostic process and improve access to care for this population.
Purpose of the Study:
- To evaluate the effectiveness of POC HCV RNA testing in an SSP setting.
- To assess the rate of HCV test result receipt among PWUD.
- To determine the initiation of the HCV treatment evaluation process following POC testing.
Main Methods:
- An observational, prospective study was conducted with clients at a health department-run SSP in Seattle, Washington.
- Participants underwent a one-step HCV testing algorithm utilizing POC HCV RNA testing (Xpert® HCV).
- Individuals testing positive for HCV were referred for onsite and offsite treatment, with same-day treatment not being available during the study period.
Main Results:
- Out of 200 participants, 15.5% tested positive for HCV RNA. Nearly all participants (97.0%) received their test results.
- Among those with a positive HCV RNA test, only 25.8% initiated the treatment evaluation process by scheduling an appointment within six months.
- A smaller proportion, 9.7%, commenced HCV medications through the SSP, with no additional participants achieving sustained virologic response (SVR4) at six months.
Conclusions:
- POC HCV RNA testing was successfully implemented in an SSP, demonstrating high rates of result return.
- Despite available treatment options, a significant gap exists in initiating the HCV treatment evaluation process among diagnosed individuals.
- Enhanced social support and streamlined protocols, including same-day treatment initiation, may be necessary to improve linkage to care and treatment outcomes.
