title: Uptake of hepatitis C specialist services and treatment following diagnosis by dried blood spot in Scotland.
abstract: BACKGROUND
  Dried blood spot (DBS) testing for hepatitis C (HCV) was introduced to Scotland in 2009. This minimally invasive specimen provides an alternative to venipuncture and can overcome barriers to testing in people who inject drugs (PWID).
  
  
  OBJECTIVE
  The objective of this study was to determine rates and predictors of: exposure to HCV, attendance at specialist clinics and anti-viral treatment initiation among the DBS tested population in Scotland.
  
  
  METHODS
  DBS testing records were deterministically linked to the Scottish HCV Clinical database prior to logistic regression analysis.
  
  
  RESULTS
  In the first two years of usage in Scotland, 1322 individuals were tested by DBS of which 476 were found to have an active HCV infection. Linkage analysis showed that 32% had attended a specialist clinic within 12 months of their specimen collection date and 18% had begun anti-viral therapy within 18 months of their specimen collection date. A significantly reduced likelihood of attendance at a specialist clinic was evident amongst younger individuals (<35 years), those of unknown ethnic origin and those not reporting injecting drug use as a risk factor.
  
  
  CONCLUSIONS
  We conclude that DBS testing in non-clinical settings has the potential to increase diagnosis and, with sufficient support, treatment of HCV infection among PWID.
authors.affiliation: East of Scotland Specialist Virology Centre, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Scotland, UK. Electronic address: g.mcallister@nhs.net.
authors.forename: Georgina
authors.initials: G
authors.lastname: McAllister
authors.affiliation: Glasgow Caledonian University, Cowcaddens Rd, Glasgow, Lanarkshire, Scotland, UK; Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland, UK.
authors.forename: Hamish
authors.initials: H
authors.lastname: Innes
authors.affiliation: Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland, UK.
authors.forename: Allan
authors.initials: A
authors.lastname: Mcleod
authors.affiliation: NHS Tayside, Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland, UK.
authors.forename: John F
authors.initials: JF
authors.lastname: Dillon
authors.affiliation: Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Hayes
authors.affiliation: Department of Infectious Diseases, Gartnavel General Hospital, Glasgow, UK.
authors.forename: Ray
authors.initials: R
authors.lastname: Fox
authors.affiliation: Glasgow Royal Infirmary, Glasgow, Scotland, UK.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Barclay
authors.affiliation: East of Scotland Specialist Virology Centre, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Scotland, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Templeton
authors.affiliation: West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, Scotland, UK.
authors.forename: Celia
authors.initials: C
authors.lastname: Aitken
authors.affiliation: West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, Scotland, UK.
authors.forename: Rory
authors.initials: R
authors.lastname: Gunson
authors.affiliation: Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland, UK; Glasgow Caledonian University, Cowcaddens Rd, Glasgow, Lanarkshire, Scotland, UK.
authors.forename: David
authors.initials: D
authors.lastname: Goldberg
authors.affiliation: Glasgow Caledonian University, Cowcaddens Rd, Glasgow, Lanarkshire, Scotland, UK; Health Protection Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland, UK.
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Hutchinson
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012606:Scotland
chemical_list: D000998:Antiviral Agents
keywords: Dried blood spots; Hepatitis C virus; Injecting drug users; Surveillance; Treatment; Viral hepatitis