QuickStart to treatment for hepatitis C

Image: The OraQuick rapid antibody test used in the QuickStart study

A new Burnet Institute hepatitis C project, QuickStart, that simplifies testing and treatment through the use of rapid antibody tests, is seeking participation from high prevalence health clinics as part of a national rollout.

Study Principal Investigator, Burnet Institute Co-Head Viral Hepatitis Elimination, Associate Professor Joe Doyle, describes QuickStart as a potential gamechanger that will get people started on treatment earlier based on their risks rather than making them wait for test results.

It’s an approach that could have a big impact in low- and middle-income countries where rapid diagnostics could replace more expensive laboratory tests.

The study will evaluate the effectiveness of a test-and-treat approach, where if the patient tests positive to hepatitis C using the rapid test – which provides a result in 20 minutes from a fingerprick of blood – they can be placed immediately on treatment instead of having to wait for confirmation from PCR tests in the laboratory.

Associate Professor Doyle said participation in the study would be best suited to health clinics, needle and syringe programs, and drug and alcohol services with a high proportion of patients at risk from hepatitis C, including people who inject drugs.

Image: Burnet Institute Research Nurse Kico Chan interviews a QuickStart study participant

“Through COVID, I think most people have become familiar with rapid tests and how cheap and simple they are compared to laboratory testing,” Associate Professor Doyle said.

“If using rapid tests to get people started on treatment works well in Australia in high prevalence clinics, this low-tech approach could prove to be even more useful and effective overseas in settings where there’s no access to laboratory backup.”

Associate Professor Doyle said QuickStart takes a patient-centred approach with the potential to change the hepatitis C treatment paradigm.

“It’s similar to the way we treat sexually transmitted infections, for example, where if someone’s got a risk and is showing early symptoms, we start them on treatment and don’t make them wait and have to come back for their results,” he said.

“This study could change the paradigm away from expensive tests and confirming disease into treating people based on their risks and getting them started on treatment earlier rather than later.”

Professor Doyle said QuickStart could be lifesaving for at-risk people who may never have considered that they have hepatitis C, and people who may have tested negative previously but unknowingly become reinfected.

“Using a fingerprick of blood is also a lot easier than collecting whole blood phlebotomy which a lot of people who inject drugs have had difficulty with and bad experiences over a long time,” he said.

While 90,000 Australians have been treated for hepatitis C with effective direct-acting antivirals that became widely available in 2016, an estimated 120,000 remain undiagnosed and at risk of being among the 600 Australians who die each year from hep C-related causes.

The QuickStart study is supported by the National Health and Medical Research Council and Gilead Sciences.

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