Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

Shahid, Imran; Alzahrani, Abdullah R.; Al‐Ghamdi, Saeed S.; Alanazi, Ibrahim M.; Rehman, Sidra; Hassan, Sajida

doi:10.3390/diagnostics11071253

Cited by 31 publications

(23 citation statements)

References 109 publications

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“…More innovative HCV screening strategies could still improve both time to HCV RNA testing and treatment uptake. Multiple clinic visits for assessment and testing, and the delay in availability of test results are considered as major barriers in the HCV care continuum, resulting in attrition at each subsequent visit [ 21 ]. Studies from the high-income countries have reported that 46% to 73% of people with HCV antibodies receive RNA testing, [ 22 , 23 ] and within low and middle-income countries, this proportion may be lower.…”

Section: Discussionmentioning

confidence: 99%

Timely Hepatitis C RNA Testing and Treatment in the Era of Direct-Acting Antiviral Therapy among People with Hepatitis C in New South Wales, Australia

Yousafzai

Alavi

Valerio

et al. 2022

Viruses

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This study aimed to identify the factors associated with timely (within four weeks) HCV RNA testing and timely (within six months) DAA initiation following HCV notification in the DAA era. We conducted a cohort study of people with an HCV notification in NSW, Australia. Notifications of positive HCV serology were linked to administrative datasets. Weights were applied to account for spontaneous clearance. Logistic regression analyses were performed. Among 5582 people with an HCV notification during 2016–2017, 3867 (69%) were tested for HCV RNA, including 2770 (50%) who received timely testing. Among an estimated 3925 people with chronic HCV infection, 2372 (60%) initiated DAA therapy, including 1370 (35%) who received timely treatment. Factors associated with timely HCV RNA testing included age (≥30 years), female sex, non-Aboriginal ethnicity, country of birth being Australia, and no history of drug dependence. Factors associated with timely treatment were age (≥30 years), male sex, non-Aboriginal ethnicity, country of birth being Australia, no history of drug dependence, and HCV/HIV co-infection. In the DAA era, 50% of people with an HCV notification did not receive timely HCV RNA testing. Most people with an HCV infection received therapy; however, DAA initiation was delayed among many.

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Section: Discussionmentioning

confidence: 99%

Timely Hepatitis C RNA Testing and Treatment in the Era of Direct-Acting Antiviral Therapy among People with Hepatitis C in New South Wales, Australia

Yousafzai

Alavi

Valerio

et al. 2022

Viruses

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“…Patients who achieve an SVR have less mortality than do those without SVR after treatment. Treatment has better effects on disease outcomes if it is started before cirrhosis[ 109 ]. To prevent long-term liver disease and HCV spread, antiviral therapy should be available in childhood.…”

Section: Hepatitis C Virusmentioning

confidence: 99%

Eliminating viral hepatitis in children after liver transplants: How to reach the goal by 2030

Sintusek¹,

Thanapirom²,

Komolmit³

et al. 2022

WJG

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Viral hepatitis infections are a great burden in children who have received liver transplant. Hepatotropic viruses can cause liver inflammation that can develop into liver graft fibrosis and cirrhosis over the long term. Immunological reactions due to viral hepatitis infections are associated with or can mimic graft rejection, rendering the condition difficult to manage. Prevention strategies using vaccinations are agreeable to patients, safe, cost-effective and practical. Hence, strategies to eliminate viral hepatitis A and B focus mainly on immunization programmes for children who have received a liver transplant. Although a vaccine has been developed to prevent hepatitis C and E viruses, its use is not licensed worldwide. Consequently, eliminating hepatitis C and E viruses mainly involves early detection in children with suspected cases and effective treatment with antiviral therapy. Good hygiene and sanitation are also important to prevent hepatitis A and E infections. Donor blood products and liver grafts should be screened for hepatitis B, C and E in children who are undergoing liver transplantation. Future research on early detection of viral hepatitis infections should include molecular techniques for detecting hepatitis B and E. Moreover, novel antiviral drugs for eradicating viral hepatitis that are highly effective and safe are needed for children who have undergone liver transplantation.

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“…Due to negative previous experiences of primary healthcare and specialized hospital care services, some patients were reluctant to initiate testing. POC and DBS have proven effective in HCV testing, diagnostics, and treatment [ 24 ]. In our real-life setting, we found that special expertise and methods were often needed due to difficulties in taking HCV RNA samples from intravenous drug users who had collapsed veins.…”

Section: Discussionmentioning

confidence: 99%

“…Besides using standard venous blood tests, HCV can be detected using point-of-care (POC) diagnostic methods. Of the POC methods, a dry blood spot (DBS) test is especially valuable for patients, as it provides an opportunity for HCV screening, diagnosis, and treatment with a low financial threshold without a need to purchase expensive equipment [ 23 , 24 ]. The use of POC methods aimed to increase the proportion of patients taking laboratory tests at their own initiative by removing the requirement to refer the patient to an external laboratory, and in addition to alleviating sample extraction from patients with a history of injecting drugs and collapsed veins.…”

Section: Methodsmentioning

confidence: 99%

Integrated care model and point of care diagnostics facilitate Hepatitis C treatment among patients receiving opioid agonist therapy: a retrospective review of medical records

Häkkinen

Tourunen

Pitkänen

et al. 2022

Subst Abuse Treat Prev Policy

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Background Hepatitis C virus (HCV) is common among individuals in opioid agonist therapy (OAT). HCV treatment has previously been unavailable for most HCV positive OAT patients in Finland. The removal of treatment restrictions and attempts to reach HCV elimination goals have increased the number of OAT patients needing HCV treatment. The objectives of this study were 1) to characterize Finnish HCV positive OAT patients and evaluate their eligibility for HCV treatment at addiction service units, and 2) to retrospectively review the outcomes of treated patients. Methods The study focused on HCV positive OAT patients (n = 235). Demographics and clinical parameters were retrospectively reviewed using the patients’ medical records. The eligibility of providing HCV treatment to patients at addiction service units were evaluated based on patients’ clinical characteristics, such as liver function and patterns of substance use. The outcomes of patients receiving HCV treatment were reviewed. Results Of HCV antibody positive OAT patients, 75% had chronic HCV. Of 103 HCV patients screened for liver fibrosis either with Fibroscan or APRI (aspartate aminotransferase to platelet ratio index), 83 patients (81%) had no indication of severe liver damage. Point of care (POC) HCV tests were used for 46 patients to lower the threshold of attending laboratory testing. All patients preferred POC testing to conventional blood testing. Twenty patients had received HCV treatment, 19 completed the treatment and achieved sustained virologic response (SVR) at the end of the treatment. Of the 18 patients available for evaluation of SVR at 12 weeks after the treatment (SVR12), 17 achieved SVR12. Conclusions The integrated model consisting of HCV diagnostics and treatment at the addiction service unit was successfully implemented within normal OAT practice.

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Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

Cited by 31 publications

References 109 publications

Timely Hepatitis C RNA Testing and Treatment in the Era of Direct-Acting Antiviral Therapy among People with Hepatitis C in New South Wales, Australia

Timely Hepatitis C RNA Testing and Treatment in the Era of Direct-Acting Antiviral Therapy among People with Hepatitis C in New South Wales, Australia

Eliminating viral hepatitis in children after liver transplants: How to reach the goal by 2030

Integrated care model and point of care diagnostics facilitate Hepatitis C treatment among patients receiving opioid agonist therapy: a retrospective review of medical records

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