Enhancing Hepatitis C Testing and Treatment Among People Who Inject Drugs Attending Needle and Syringe Programs

NCT ID: NCT04014179

Last Updated: 2025-07-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

2700 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-27

Study Completion Date

2026-07-31

Brief Summary

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This project aims to evaluate two strategies of Hepatitis C virus (HCV) testing compared to standard of care among people who inject drugs at needle and syringe program (NSP) services in Australia, to see if it can improve the number of people who start treatment following an HCV diagnosis:

1. HCV testing from collected dried blood spots sent to a central laboratory
2. HCV testing using a point-of-care device at the NSP site
3. HCV testing using standard of care at the NSP site

Detailed Description

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The TEMPO study will compare dried blood spot testing and point-of-care HCV RNA testing to standard of care as strategies to enhance HCV treatment uptake among people with HCV and recent injecting drug use attending NSP services. Peer support to enhance engagement and facilitate linkage to nursing care will be provided in the intervention arms of this study.

The study is a cluster randomized controlled trial. The sites (clusters) will be primary NSPs which provide services to people who inject drugs and have capacity to provide hepatitis C treatment services. The sites will be located in Australia.

Eighteen NSPs (the clusters) will be randomly allocated to receive point-of-care HCV RNA testing (6 clusters), dried blood spot testing (6 clusters) or standard of care (6 clusters).

At screening, participants will be tested for HCV infection with dried blood spot, point-of-care or standard of care, depending on cluster randomisation.

Screening will continue until a total of 150 HCV RNA positive participants (\~25 participants per site) are enrolled in the dried blood spot arm, 150 HCV RNA positive participants are enrolled in the point-of-care arm, and 150 participants are enrolled in the standard of care arm. Hence a total of 450 HCV RNA positive participants.

HCV RNA negative participants will have no further assessments or visits as part of the study protocol.

Participants who are HCV RNA positive will be enrolled in the follow-up cohort and will be assessed for treatment eligibility. If eligible, they will be treated as per standard of care with a pharmaceutical benefits scheme (PBS) approved pan-genotypic HCV DAA treatment. Participants will be encouraged to take the first dose on the day of treatment work-up where possible. On-treatment and post-treatment testing and monitoring will be based on the site investigator as per standard clinical practice.

All HCV RNA positive participants will be followed up at 12 weeks, 24 weeks and 12 months post enrolment.

Conditions

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Hepatitis C Hepatitis C, Chronic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Dried Blood Spot (Intervention)

Blood samples will be tested for HCV RNA from dried blood spot cards.

Group Type EXPERIMENTAL

Aptima HCV Quant DX Assay

Intervention Type DIAGNOSTIC_TEST

The Aptima HCV Quant Dx assay is a real-time transcription-mediated amplification test.

The assay is used for both detection and quantitation of hepatitis C virus (HCV) RNA in fresh and frozen human serum and plasma from HCV-infected individuals, and in this study from dried blood spots. The HCV RNA result from the Aptima assay will be used to initiate HCV treatment.

Point-of-care RNA (Intervention)

Blood samples will be tested for HCV RNA using the Xpert HCV Viral Load Fingerstick point-of-care assay.

Group Type EXPERIMENTAL

Xpert HCV Viral Load Fingerstick

Intervention Type DIAGNOSTIC_TEST

The Cepheid Xpert HCV Viral Load (VL) Fingerstick assay is an in vitro nucleic acid amplification test designed for the quantitation of Hepatitis C Virus (HCV) DNA in human whole blood using the automated GeneXpert Systems. The HCV RNA result from the Xpert test will be used to initiate HCV treatment.

Standard of Care (Control)

Sites will continue with their standard of care for hepatitis C testing.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Xpert HCV Viral Load Fingerstick

The Cepheid Xpert HCV Viral Load (VL) Fingerstick assay is an in vitro nucleic acid amplification test designed for the quantitation of Hepatitis C Virus (HCV) DNA in human whole blood using the automated GeneXpert Systems. The HCV RNA result from the Xpert test will be used to initiate HCV treatment.

Intervention Type DIAGNOSTIC_TEST

Aptima HCV Quant DX Assay

The Aptima HCV Quant Dx assay is a real-time transcription-mediated amplification test.

The assay is used for both detection and quantitation of hepatitis C virus (HCV) RNA in fresh and frozen human serum and plasma from HCV-infected individuals, and in this study from dried blood spots. The HCV RNA result from the Aptima assay will be used to initiate HCV treatment.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

Attendees of the NSP service are eligible for inclusion if the following criteria are met:

1. Provided written informed consent
2. ≥ 18 years of age
3. Recent injecting drug use - defined as self-reported use within the previous six months.

Exclusion Criteria

a. Is unable or unwilling to provide informed consent or abide by the requirements of the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Kirby Institute

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Bankstown NSP

Bankstown, New South Wales, Australia

Site Status

WSLHD Drug Health - Blacktown NSP

Blacktown, New South Wales, Australia

Site Status

Coffs Harbour Primary NSP

Coffs Harbour, New South Wales, Australia

Site Status

Gosford NSP

Gosford, New South Wales, Australia

Site Status

Grafton Primary NSP

Grafton, New South Wales, Australia

Site Status

Kempsey Primary NSP

Kempsey, New South Wales, Australia

Site Status

Liverpool Southwest NSP

Liverpool, New South Wales, Australia

Site Status

WSLHD Drug Health - Mt Druitt NSP

Mount Druitt, New South Wales, Australia

Site Status

Orana Centre

Wollongong, New South Wales, Australia

Site Status

Alcohol and Drug Harm Reduction Biala

Brisbane, Queensland, Australia

Site Status

Severin St NSP (Youth Link)

Cairns, Queensland, Australia

Site Status

Inala

Inala, Queensland, Australia

Site Status

Kobi House

Toowoomba, Queensland, Australia

Site Status

UC Adelaide

Adelaide, South Australia, Australia

Site Status

Wonggangga Turtpandi Aboriginal Primary Health Care Services

Adelaide, South Australia, Australia

Site Status

Northern DASSA

Elizabeth, South Australia, Australia

Site Status

Noarlunga Health Precinct

Old Noarlunga, South Australia, Australia

Site Status

Countries

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Australia

Other Identifiers

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VHCRP1904

Identifier Type: -

Identifier Source: org_study_id

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