{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:43:11Z","timestamp":1781710991368,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Hepatitis C remains a significant global health problem, particularly among people who inject drugs. To achieve Australia's 2030 elimination targets, efficient testing strategies are needed. The OraQuick rapid antibody test provides results in 20\u2009min, but many non\u2010viraemic individuals with resolved infections test positive, potentially leading to unnecessary confirmatory RNA testing. Reducing the read time to five minutes has been proposed to reduce false positives and improve efficiency, but its impact on viremia detection is unclear. This study utilised data from the QuickStart study, a randomised controlled trial investigating different rapid testing pathways and a same\u2010day test\u2010and\u2010treat model. Participants underwent OraQuick rapid antibody testing with results read at both five and 20\u2009min, followed by confirmatory RNA testing. Among 298 participants with OraQuick and RNA test results, the 20\u2010min OraQuick test was positive for all 79 viraemic individuals and 156 non\u2010viraemic individuals. At five minutes, positive results decreased to 77 (97.5%) of viraemic and 135 (87%) non\u2010viraemic individuals with positive 20\u2010min results. Using a five\u2010minute result to trigger RNA testing would have reduced unnecessary RNA testing by 13% in our cohort at the cost of missing 2.5% of viraemic individuals. A five\u2010minute read time could improve efficiency by reducing unnecessary RNA testing, but confirmatory RNA testing remains essential to distinguish active from resolved infections. The balance between efficiency and accuracy may vary contextually, reflecting differing rates of resolved infections. This approach may be beneficial in resource\u2010limited settings, but the potential for missed viremia must be considered.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    number; NCT05016609\n                  <\/jats:p>","DOI":"10.1111\/jvh.70043","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T07:44:28Z","timestamp":1751528668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Balancing Efficiency and Accuracy in Hepatitis C Rapid Antibody Testing: Insights From a Cluster Randomised Crossover Trial"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-9732","authenticated-orcid":false,"given":"K.","family":"Heath","sequence":"first","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Guzman","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4525-0727","authenticated-orcid":false,"given":"I.","family":"Elsum","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8499-8490","authenticated-orcid":false,"given":"A. J.","family":"Wade","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Allardice","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Kasza","sequence":"additional","affiliation":[{"name":"Monash University School of Public Health and Preventive Medicine  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Bryant","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. J.","family":"Thompson","sequence":"additional","affiliation":[{"name":"St. Vincent's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Stoov\u00e9","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Snelling","sequence":"additional","affiliation":[{"name":"University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-0798","authenticated-orcid":false,"given":"N.","family":"Scott","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Spelman","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1321-2552","authenticated-orcid":false,"given":"J.","family":"Richmond","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Howell","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"},{"name":"Monash University School of Public Health and Preventive Medicine  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Andric","sequence":"additional","affiliation":[{"name":"University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Dietze","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Higgs","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sacks\u2010Davis","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Forbes","sequence":"additional","affiliation":[{"name":"Monash University School of Public Health and Preventive Medicine  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5055-3266","authenticated-orcid":false,"given":"M. E.","family":"Hellard","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"},{"name":"Monash University School of Public Health and Preventive Medicine  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. E.","family":"Pedrana","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"},{"name":"Monash University School of Public Health and Preventive Medicine  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. S.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Victoria Australia"},{"name":"The Alfred Department of Infectious Diseases Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization \u201cHepatitis C: Fact Sheet.\u201d accessed June 11 2025 https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/hepatitis\u2010c."},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization \u201cGlobal Health Sector Strategy on Viral Hepatitis 2016\u20132021 \u201d(2016) Geneva Switzerland."},{"key":"e_1_2_10_4_1","volume-title":"Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022\u20132030","author":"World Health Organization","year":"2022"},{"key":"e_1_2_10_5_1","unstructured":"S.Blach \u201cUpdated Evaluation of Global Progress Towards HBV and HCV Elimination Preliminary Data Through 2021 \u201dIn: American Association for the Study of Liver Diseases; Nov 4\u20138 2022."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30366-6"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00408-9"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14393"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00018-3"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00461-8"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.109050"},{"key":"e_1_2_10_12_1","unstructured":"Kirby Institute \u201cAustralia's Progress Towards Hepatitis C Elimination\u2014Annual Report 2023 \u201d(2023) https:\/\/www.kirby.unsw.edu.au\/research\/reports\/australias\u2010progress\u2010towards\u2010hepatitis\u2010c\u2010elimination\u2010annual\u2010report\u20102023."},{"key":"e_1_2_10_13_1","unstructured":"National Hepatitis C Testing Policy Expert Reference Committee \u201cNational Hepatitis C Testing Policy \u201daccessed June 25 2024 https:\/\/testingportal.ashm.org.au\/national\u2010hcv\u2010testing\u2010policy\/."},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiad453"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2017.1400385"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2007.01.008"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70250-0"},{"key":"e_1_2_10_18_1","unstructured":"\u201cHCVPOCT: National Hepatitis C Point\u2010of\u2010Care Testing Program \u201daccessed July 19 2024 https:\/\/hepcpoct.com.au\/about\/funding."},{"key":"e_1_2_10_19_1","unstructured":"J.Grebeley \u201cA National Program to Scale\u2010Up Point\u2010Of\u2010Care Testing and Treatment for Hepatitis C Infection in Australia 2022\u20132024 \u201dIn: 14th Australasian Viral Hepatitis Conference. Darwin 2024."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30075-4"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14983"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.07.058"},{"issue":"7","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-083502","article-title":"Same\u2010Visit Hepatitis C Testing and Treatment to Accelerate Cure Among People Who Inject Drugs (The QuickStart Study): A Cluster Randomised Cross\u2010Over Trial Protocol","volume":"14","author":"Heath K.","year":"2024","journal-title":"BMJ Open"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0254028"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1086\/428128"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2018.07.013"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-021-00260-8"},{"key":"e_1_2_10_30_1","unstructured":"The Kirby Institute \u201cMonitoring Hepatitis C Treatment Uptake in Australia \u201d(2024) https:\/\/www.kirby.unsw.edu.au\/sites\/default\/files\/documents\/Monitoring\u2010hepatitis\u2010C\u2010treatment\u2010uptake\u2010in\u2010Australia\u2010Issue\u201014\u2010July\u20102024_0.pdf."},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsoc.2020.593925"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.229"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac225"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T05:02:04Z","timestamp":1764392524000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.70043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,3]]},"references-count":32,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/jvh.70043"],"URL":"https:\/\/doi.org\/10.1111\/jvh.70043","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,3]]},"assertion":[{"value":"2024-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70043"}}