Home Access Hepatitis C Test Kit Training

Hepatitis Education Project

Seattle, Washington

Hepatitis Education Project

HEP is a non-profit organization based in Seattle that offers resources, support and services to people affected by hepatitis.

HEP receives Home Access test kits for free through the WA Dept. of Health, as a result we’re able to offer the test for free in different settings around King County.

The Liver & Hepatitis3

The Liver Performs over 500 different functions…

Filter, Factory, Storage facility Regenerative Non-complaining

Hepatitis is a general term meaning liver inflammation… “Hepa” refers to the liver Any “itis” means inflammation

Causes of Hepatitis4

Viruses Alcohol Drugs/prescriptions Herbs Genetic disorders Obesity

Hepatitis viruses5

Hepatitis A: fecal-oral transmission cycle; acute infection; contaminated food or water.

Hepatitis B: blood and body fluids; can occur as an acute or chronic infection; sexual, mother-to-child and injection drug use.

Hepatitis C: blood borne infection; direct blood-to-blood contact.

All 3 viruses can remain active/infectious outside of the body for several days.

Hepatitis B & Hepatitis C

2 millions Americans HBV+. In the United States most

people get over this infection on their own (90-95%).

People infected for a long time have a higher risk of getting liver cancer.

People with chronic HBV can get liver cancer before cirrhosis.

Cancer screening is important. Treatment is available for

those who need it; there is no cure for HBV.

5 million Americans HCV+. Approximately 75-80% of

those exposed to HCV will develop the chronic infection.

At least 10,000 deaths from HCV annually in U.S.

Leading cause of liver transplantation in the U.S.

People with chronic HCV are at risk for cirrhosis, liver cancer and liver failure.

40% of patients are cured on current treatment

Hepatitis B (HBV) Hepatitis C (HCV)

When does infection happen?

Hep C: blood-to-blood contact

Injection drug useIntranasal drug use (snorting cocaine) Tattooing/piercing (needles & ink)Blood-transfusions (pre-1992)Re-use of medical equipment

Sharing personal hygiene tools (razors, toothbrushes)Occupational exposures: firefighters, ER nurses, EMTs

Hep B: blood-to-blood or bodily fluid contact

All of the above, plus…Mother-to-childSexual

Know This

The hepatitis C virus can be infectious out of the body for up

to 4 days.

The hepatitis B virus can be infectious out of the body for up

to 8 days.

Who should get tested?

Anyone who has ever injected drugs, vitamins and steroids.

Anyone who has received a tattoo or piercing from an uncertified tattoo/piercing parlor.

Anyone who frequently shares cocaine papers that may have been contaminated with blood.

Persons who received a blood transfusion prior to 1992 or clotting factors prior to 1987.

Persons who received an organ transplant prior to 1992.

Healthcare workers, EMTs, public safety workers who may have had an occupational exposure (needle stick).

Persons who were ever on long-term kidney dialysis.

The Home Access System

The Home Access System provides all the tools needed to:

Determine risk

Collect a fingerstick sample

Send to a CLIA-certified, CAP accredited laboratory

Receive individual result reports

Receive aggregate data report

Pre-test discussion Greet and make client feel comfortable. Explain that this is a screening test; if the results are

positive that only means that the person has been exposed to the virus – it doesn’t necessarily mean that he/she is currently infected with the virus. If the test results come back positive, the client must get a 2nd test to determine whether the virus is present. This 2nd test is called a confirmatory/PCR test – PHRA has a list of clinics that offer this test.

Note that if the client has ever tested positive for hepatitis C in the past he/she will definitely test positive on this test, this is because this test is screening for antibodies and not the actual virus.

Pre-test Discussion Continued… Briefly review how hepatitis C is

transmitted. Explain that the results of the test will take

about 3 weeks to be processed and ask the client to fill out the screening form.

Ensure that the client’s name and address are written legibly.

Ask if he/she has any questions before you begin.

Complete the paperwork In the space provided, write the date of

collection. Note if the date is missing or incorrect the lab will not run the sample (samples must be received by the lab within 14 days of collection).

Write the given pin number on the screening form.

Tear off the yellow portion of the card and give it to the client Staple the yellow portion to the top right

corner of the screening form.

Prepare hands for testing Have client wash his/her hands or use

hand sanitizer

Rub hands together vigorously and/or shake – this will increase heart rate and get blood flowing

Select the Puncture Site Wipe puncture site with alcohol wipe

Use ring or middle finger as they tend to be less calloused than the thumb or index finger

Place drops of blood on card until circle is completely filled

Collect the Sample Clean the finger with an alcohol wipe

FIRMLY press finger on the lancet

Place blood drops on collection card, completely fill the circle

Place bandage on finger (bring extras!)

Tips for Collecting an Adequate Sample

Wiping with gauze pad between drops may help increase blood flow.

Wait for larger drops of blood to form before touching them to the circle.

Place drops next to each other NOT on top of each other. Do not worry about staying inside the circle. If necessary prick the finger again, or prick another finger.

Tips for Collecting an Adequate Sample cont’d… Blood must soak through to the back of the

card

Do not place blood on the back of the card

Gently squeeze finger from base to puncture site

Package the Sample

Allow sample to dry for 15-30 minutes

Remove foil pouch from clear wrapper

Place sample inside Foil Pouch – do not remove desiccant, this will keep the sample stable during shipment to our lab

Place unsealed foil pouches inside of the “Specimens” envelope for HEP to pick up and process

Results Results will be available in roughly 3 weeks from

date that test is mailed to lab Test results will be provided by HEP. Clients who

receive a positive test result will be contacted by phone whenever possible. Those with negative test results will receive the results by mail

For clients that do not have a mailing address or phone number, provide them with HEP’s toll free telephone number

Confirmed positives must be reported to DOH

Questions…

Contact the Hepatitis Education Project:(206) 732-0311 or (800) 218-6932

www.hepeducation.org