Improving HCV Screening in Addiction Care Centers with Plasma Separation Cards

TL;DR

Using finger-prick blood samples on special cards improved HCV screening in addiction centers, especially for those who can't undergo traditional blood draws.

Contribution

Demonstrates the effectiveness of plasma separation cards for HCV screening in high-risk populations with limited access to traditional diagnostics.

Findings

79.6% of PSC clients tested positive for HCV antibodies, compared to 9.1% of venipuncture clients.

PSC clients contributed to 62.5% of active HCV infections detected, with a 34.9% HCV RNA positivity rate.

Refusal or inability to undergo venipuncture was associated with a 26.3 odds ratio for active HCV infection.

Abstract

Globally, 50 million people are infected with hepatitis C virus (HCV), many of whom are people who inject drugs. These individuals face healthcare barriers, necessitating innovative diagnostic tools. This study evaluated the impact of cobas plasma separation cards (PSCs) for dry plasma collection in Barcelona’s outpatient drug addiction centers (CAS). From February to December 2021, nine CASs were invited to implement PSC for HCV screening; three centers participated, allowing for the assessment of its impact on HCV detection. Of the 679 clients screened, 54 (8%) provided finger-prick blood samples via PSC due to their refusal or inability to undergo venipuncture. Overall, 100 (14.7%) clients tested positive for HCV antibodies, with 24 (24%) confirmed as HCV-RNA positive. Among venipuncture clients, 9.1% had positive antibodies, with 15.8% showing active infection. In contrast, 79.6% of PSC clients had positive antibodies and 34.9% had detectable HCV RNA, contributing to 62.5% of the active infections detected. The odds ratio was 26.3, indicating that refusal or inability to undergo venipuncture correlated with a significantly higher burden of active HCV infection. The findings highlight PSC as a valuable alternative for diagnosing HCV in people with substance use disorders, addressing accessibility barriers and improving linkage to care in high-risk populations.

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