摘要：HCV has surpassed HIV as a cause of death in the United States and is particularly prevalent among injection drug users. I examined the availability of on-site HCV testing in a nationally representative sample of opioid treatment programs. Nearly 68% of these programs had the staff required for HCV testing, but only 34% offered on-site testing. Availability of on-site testing increased only slightly with the proportion of injection drug users among clients. The limited HCV testing services in opioid treatment programs is a key challenge to reducing HCV in the US population. HCV recently surpassed HIV as a cause of death in the United States. 1,2 Approximately 3.2 million people nationwide are living with chronic hepatitis, but most are unaware of their status because of limited opportunities for testing. 3–6 Persons who inject drugs are particularly at risk for HCV infection as a result of sharing and reusing of needles. 4,7 The estimated prevalence of antibodies to HCV (anti-HCV) among injection drug users ranges from 35% to 65%. 8 The Centers for Disease Control and Prevention (CDC) thus recommends routine HCV testing for all current or former injection drug users. 1,9 Offering HCV testing services in drug abuse treatment programs could help increase HCV case finding and reduce transmission. 10,11 It could also help foster the adoption of preventive behaviors: knowledge of one’s anti-HCV status may indeed lead to safer injection practices (or other protective behaviors). 12,13 I examined the availability of on-site HCV testing services in opioid treatment programs (i.e., physical facilities with resources dedicated specifically to treating opiate dependence with methadone, buprenorphine, or both). 14,15 Opioid treatment programs treat both persons who inject drugs and people who have opiate addiction but do not inject drugs. The current recommended HCV testing protocol requires the collection of venous blood, performed by qualified staff (i.e., phlebotomists). 16 However, the availability of (1) human resources required to offer HCV testing services and (2) on-site HCV testing services at opioid treatment programs nationwide is not known. I examined relations among the availability of on-site HCV testing services, human resources for HCV testing, and the proportion of injection drug users among opioid treatment program clients.
