Innovations in Hepatitis C Screening and Treatment

Abstract

New therapies offer hope for a cure to millions of persons living with hepatitis C virus (HCV) infection. HCV elimination is a global goal that will be difficult to achieve using the traditional paradigms of diagnosis and care. The current standard has evolved toward universal HCV screening and treatment, to achieve elimination goals. There are several steps between HCV diagnosis and cure with major barriers along the way. Innovative models of care can address barriers to better serve hardly reached populations and scale national efforts in the United States and abroad. Herein, we highlight innovative models of HCV care that aid in our progress toward HCV elimination.

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

“…From 71 million people living with HCV worldwide, it has been estimated that two-thirds of them are living in LMICs with poor access to HCV testing facilities and treatment uptake [ 10 ]. Furthermore, worldwide, 19% of people living with HCV have been diagnosed and less than 5% diagnosed with HCV live in LMICs [ 10 ].…”

“…From 71 million people living with HCV worldwide, it has been estimated that two-thirds of them are living in LMICs with poor access to HCV testing facilities and treatment uptake [ 10 ]. Furthermore, worldwide, 19% of people living with HCV have been diagnosed and less than 5% diagnosed with HCV live in LMICs [ 10 ]. Surprisingly, only 20% of CHC-infected patients know about their active infection status and only 15% had been treated with DAA regimens by the end of 2017 [ 9 ].…”

“…Sub-Saharan African (SSA) countries reported 34.4 times more new infections and Central and Eastern Europe had 12.4 times more new infections than cure in 2016 [ 9 ]. China has the largest epidemic size with 9.8 million active HCV infections, followed by Pakistan (7.1 million) and India (6.2 million) [ 9 , 10 ]. In the US, HCV is still considered the most common blood-borne infection affecting 2 million people, and more than half of them being reported unaware of their infection [ 10 ].…”

“…China has the largest epidemic size with 9.8 million active HCV infections, followed by Pakistan (7.1 million) and India (6.2 million) [ 9 , 10 ]. In the US, HCV is still considered the most common blood-borne infection affecting 2 million people, and more than half of them being reported unaware of their infection [ 10 ]. Geographical distribution of new HCV incidences demonstrates that more than half of them live in the Asian Pacific region (29.6 million) and a substantial number within the Western European region (2.4 million) [ 16 ].…”

“…Even the hepatitis C elimination strategies are ambiguous both in respect of infection diagnosis and treatment uptake in some resource-rich nations as their national hepatitis care plan exposes serious flaws in their health care systems [ 9 ]. Overall, the HCV diagnostic rates are low in general populations even in developed countries that have adopted a routine, population-based HCV screening [ 10 ]. Although taking into account the WHO goals of HCV elimination and prevention guidelines in their national hepatitis plan by WHO member nations, millions are missing in hot-spots and highly prevalent areas of HCV transmission in resource-constrained nations and in many LMICs where testing and treatment costs are sky-high, less accessible due to poor health care infrastructure, and have poor-quality management systems for relaying results in laboratory testing services [ 9 ].…”