Same-visit Hepatitis C Testing and Treatment (The QuickStart Study)

NCT ID: NCT05016609

Last Updated: 2023-11-13

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

1800 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-09

Study Completion Date

2024-06-30

Brief Summary

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The QuickStart study aims to assess the impact of three models of HCV care on HCV treatment uptake and cure among people who inject drugs. Rapid point-of-care (POC) HCV testing and test-and-treat strategies will be utilised in primary health care settings across Australia.

Detailed Description

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The QuickStart Study will explore models of point-of-care HCV testing and a same-day test and treat model to determine the impact of these models on HCV treatment initiation and cure. The study is a cluster cross-over randomised controlled trial. Sites are primary care services in Australia who provide services to people who inject drugs (PWID) and who routinely prescribe treatment for hepatitis C. Clinical services with a primary care practitioner and/or nurse experienced in providing DAA treatment to high numbers of PWID will be recruited to the study. A total of 30 services will be recruited with each service enrolling approximately 60 participants across an intervention and control period. Key participant eligibility include a history of injecting drug use and no previous treatment for HCV with direct acting antivirals.

Each site will participate in a control comparison period in addition to one of three interventions. The three interventions involve:

A) A rapid HCV antibody test using a fingerprick sample and for anybody subsequently diagnosed with hepatitis C, management and treatment will be according to standard of care.

B) A rapid HCV antibody test followed by a POC HCV RNA test for those who return a reactive antibody result. Both these will use a fingerprick sample and for anybody diagnosed with hepatitis C, management and treatment will be according to standard of care.

C) A rapid HCV antibody test using a fingerprick sample and for participants who return a reactive result, an initial starter pack of DAA prior to a confirmed HCV RNA diagnosis.

Conditions

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Hepatitis C

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

A cluster cross-over randomised controlled trial with cluster randomisation performed at the site level. Each site will be randomised to one of the three interventions and one standard of care period. All participants will receive the intervention or comparator that has been allocated to the service they present at.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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POC HCV antibody group (Arm A)

This group will receive POC HCV antibody testing via fingerprick using the OraQuick HCV antibody test (OraSure) in addition to the standard-of-care whole-blood conventional laboratory-based HCV PCR viral load testing. Follow up and management of any treatment will be through usual standard-of-care. Participants in this group will also fill out a short behavioural questionnaire and a clinical questionnaire.

Group Type EXPERIMENTAL

OraQuick HCV Antibody test (OraSure Technologies, Inc)

Intervention Type DEVICE

The OraQuick HCV test is a point of care antibody test for detecting HCV antibodies in fingerstick blood. The test takes 20 minutes to provide a result. Appropriate pre- and post-test counselling will be provided to participants.

POC HCV RNA group (Arm B)

This group will receive POC HCV antibody testing using the OraQuick HCV antibody test. Participants in this group who return a positive POC HCV antibody result will receive POC HCV viral load testing via fingerstick using the Xpert HCV Viral Load Finger-stick Point-of-Care test (Cepheid) in addition to the standard-of-care whole-blood conventional laboratory-based HCV PCR viral load testing. Follow up and management of any treatment will be through usual standard-of-care. Participants in this group will also fill out a short behavioural questionnaire and a clinical questionnaire.

Group Type EXPERIMENTAL

OraQuick HCV Antibody test (OraSure Technologies, Inc)

Intervention Type DEVICE

The OraQuick HCV test is a point of care antibody test for detecting HCV antibodies in fingerstick blood. The test takes 20 minutes to provide a result. Appropriate pre- and post-test counselling will be provided to participants.

Xpert HCV Viral Load Finger-stick Point-of-Care test (Cepheid)

Intervention Type DEVICE

Xpert® HCV VL Fingerstick is an in vitro reverse transcription polymerase chain reaction (RT-PCR) assay for the detection and quantification of Hepatitis C Virus (HCV) RNA in human venous and capillary fingerstick EDTA whole blood. Only participants who return a reactive OraQuick HCV Antibody test will be offered the Xpert® HCV VL Fingerstick test. Appropriate pre- and post-test counselling will be provided to participants.

Test and treat group (ArmC)

This group will receive POC HCV antibody testing using the OraQuick HCV antibody test. Participants in this group who return a positive POC HCV antibody result will be provided a starter pack of HCV treatment (epclusa). POC tests results will be confirmed through standard-of-care whole-blood conventional laboratory-based HCV PCR viral load testing. HCV RNA positive participants will continue treatment. Participants in this group will also fill out a short behavioural questionnaire and a clinical questionnaire.

Group Type EXPERIMENTAL

OraQuick HCV Antibody test (OraSure Technologies, Inc)

Intervention Type DEVICE

The OraQuick HCV test is a point of care antibody test for detecting HCV antibodies in fingerstick blood. The test takes 20 minutes to provide a result. Appropriate pre- and post-test counselling will be provided to participants.

Sofosbuvir/Velpatasvir (Gilead)

Intervention Type DRUG

Participants with a detectable HCV antibody will be offered treatment with sofosbuvir/velpatasvir.

Control

This group will receive the standard of care for HCV testing and treatment. Participants in this group will fill out a short behavioural questionnaire and a clinical questionnaire.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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OraQuick HCV Antibody test (OraSure Technologies, Inc)

The OraQuick HCV test is a point of care antibody test for detecting HCV antibodies in fingerstick blood. The test takes 20 minutes to provide a result. Appropriate pre- and post-test counselling will be provided to participants.

Intervention Type DEVICE

Xpert HCV Viral Load Finger-stick Point-of-Care test (Cepheid)

Xpert® HCV VL Fingerstick is an in vitro reverse transcription polymerase chain reaction (RT-PCR) assay for the detection and quantification of Hepatitis C Virus (HCV) RNA in human venous and capillary fingerstick EDTA whole blood. Only participants who return a reactive OraQuick HCV Antibody test will be offered the Xpert® HCV VL Fingerstick test. Appropriate pre- and post-test counselling will be provided to participants.

Intervention Type DEVICE

Sofosbuvir/Velpatasvir (Gilead)

Participants with a detectable HCV antibody will be offered treatment with sofosbuvir/velpatasvir.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* current or former PWID (i.e., injected drugs at least once)
* aged 18 years or over
* attending a participating PHC for any reason
* no previous treatment with DAAs for HCV
* failed interferon based treatment for HCV in the past (i.e., did not achieve cure)
* Medicare eligible
* able to speak and understand English

Exclusion Criteria

* women known to be currently pregnant or who are breastfeeding
* individuals self-reporting to be currently engaged in treatment for HCV
* unable to provide informed consent
* tested for HCV in the past 3 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Macfarlane Burnet Institute for Medical Research and Public Health Ltd

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joseph Doyle, MBBS, PhD

Role: PRINCIPAL_INVESTIGATOR

Burnet Institute

Locations

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Mediclinic Australia

Clayton South, Victoria, Australia

Site Status RECRUITING

Innerspace

Collingwood, Victoria, Australia

Site Status RECRUITING

Corio Community Health Centre

Corio, Victoria, Australia

Site Status RECRUITING

Cohealth Fitzroy

Fitzroy, Victoria, Australia

Site Status RECRUITING

Homeless Healthcare

Highgate, Western Australia, Australia

Site Status RECRUITING

Cockburn Wellbeing

Success, Western Australia, Australia

Site Status RECRUITING

Countries

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Australia

Central Contacts

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Caitlin Douglass, BHSc(Hons)

Role: CONTACT

+61404707275

Mellissa Bryant

Role: CONTACT

+61392822162

Facility Contacts

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Ainslee O'Donnell

Role: primary

+61395441555

Tanya Karapouloutidis

Role: primary

+61394486710

Inga Tribe

Role: primary

+613 4215 7100

Tanya Karapouloutidis

Role: primary

(03) 9448 5531

Denice Wallis

Role: primary

+618 62602092

Karen Heslop

Role: primary

+618 9266 2090

References

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Heath K, Guzman R, Elsum I, Wade AJ, Allardice K, Kasza J, Bryant M, Thompson AJ, Stoove M, Snelling T, Scott N, Spelman T, Anderson DA, Richmond J, Howell J, Andric N, Dietze P, Higgs P, Sacks-Davis R, Forbes A, Hellard ME, Pedrana AE, Doyle JS. Balancing Efficiency and Accuracy in Hepatitis C Rapid Antibody Testing: Insights From a Cluster Randomised Crossover Trial. J Viral Hepat. 2025 Aug;32(8):e70043. doi: 10.1111/jvh.70043.

Reference Type DERIVED
PMID: 40607684 (View on PubMed)

Doyle JS, Heath K, Elsum I, Douglass C, Wade A, Kasza J, Allardice K, Von Bibra S, Chan K, Camesella B, Guzman R, Bryant M, Thompson AJ, Stoove MA, Snelling TL, Scott N, Spelman T, Anderson D, Richmond J, Howell J, Andric N, Dietze PM, Higgs P, Sacks-Davis R, Forbes AB, Hellard ME, Pedrana AE. Same-visit hepatitis C testing and treatment to accelerate cure among people who inject drugs (the QuickStart Study): a cluster randomised cross-over trial protocol. BMJ Open. 2024 Jul 2;14(7):e083502. doi: 10.1136/bmjopen-2023-083502.

Reference Type DERIVED
PMID: 38960465 (View on PubMed)

Other Identifiers

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HREC/64731/Alfred-2020-217547

Identifier Type: -

Identifier Source: org_study_id

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