6 recent reports on HCV screening rates, strategies

The direct-acting antiviral era has seen a significant increase in the number of patients with hepatitis C clearing their infection. Along with this, public awareness of the disease and its highly effective cure has increased. However, many barriers still exist to finding all patients with HCV to achieve the WHO’s goal of global elimination.

The following reports include innovative strategies and research data on screening and testing for HCV among different patient demographics and settings, including point-of-care tests, screening in the primary care setting, and survey data on screening rates.

European survey asserts insufficient HCV prevention in prisons

Results of a survey of liver patient groups from 25 European countries showed that a minority of European prisons provide adequate infectious disease prevention, such as harm reduction programs and hepatitis C screening.

“Given the high prevalence of hepatitis C virus (HCV) among prisoners, disease prevention measures, such as opioid substitution therapy and needle and syringe programs, are currently insufficient in European prison settings,” Rob Bielen, MD, from the Hasselt University in Belgium, and colleagues wrote. “Only a minority of HCV-infected patients in prisons have access to direct-acting antiviral therapy, which can easily and effectively cure HCV.” Read more

Bi-annual liver cancer screening for cirrhosis improves diagnosis, survival

Compliance with hepatocellular carcinoma surveillance correlated with early diagnosis, better allocation of curative treatment and longer overall survival among patients with hepatitis C- or hepatitis B-associated compensated cirrhosis, according to a recently published study.

“Monitoring for HCC in patients with cirrhosis, based on bi-annual ultrasound examination is recommended by international guidelines,” Charlotte Costentin, MD, from the Hôpital Henri Mondor in France, and colleagues wrote. “Improving compliance with surveillance guidelines should translate into a significant improvement in the prognosis of this deadly cancer.” Read more

Community-based primary care fibrosis screening feasible for chronic HCV

Researchers using liver stiffness measurement found significant and comparable prevalence of advanced fibrosis between patients with chronic hepatitis C recruited from primary care practices and those recruited from a hospital cohort, according to a recently published study.

“In order to reach the WHO goal of [chronic HCV (CHC)] elimination, the engagement of nonspecialist physicians in CHC treatment and management is paramount,” Stephen Bloom, PhD, from Eastern Health in Victoria, Australia, and colleagues wrote. “Our study suggests a comprehensive community-based CHC screening program is feasible and may identify those at risk of liver-related events and [hepatocellular carcinoma (HCC)].” Read more

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Only 30% of HCV-exposed infants screened for infection

The prevalence of hepatitis C infection among one cohort of pregnant women increased by 60% between 2006 and 2014, with only 30% of infants born to infected mothers screened for the infection, according to a retrospective cohort study published in Pediatrics.

“This problem is likely widespread beyond our area,” Catherine Chappell, MD, MSc, from the departments of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh and Magee-Womens Research Institute, told HCV Next. “Some reasons as to why an infant would not be screened for hepatitis C might include that the pediatrician does not know about the exposure because mothers might worry about the stigma, medical records related to the mother’s infection might not transfer to the baby’s records or exposure may have been forgotten by the time screening is done at 18 months of age.” Read more

HCV point-of-care diagnostics remove barriers to care

Findings presented at the International Liver Congress suggest that point-of-care testing for hepatitis C virus infection in community clinics in Australia was acceptable to patients and feasible, specifically for people who inject drugs, or PWID.

Bridget Williams, MD, public health registrar for the Burnet Institute in Melbourne, Australia, and colleagues identified 174 individuals who were at high risk for HCV from three clinics with needle and syringe exchange programs (NSP) in the Melbourne metro area. Overall, the mean age of participants was 41 years, 67% were male, 88% had injected drugs within the past 6 months and 53% had shared injecting equipment within the past 6 months. Read more

Point-of-care HCV test shows high accuracy in real-life clinic setting

A novel point-of-care test for hepatitis C meets the recent Foundation for Innovation in New Diagnostics and World Health Organization’s Target Product Profile for HCV decentralized testing in low-income and middle-income countries, according to a recently published study.

“Although DAAs for HCV cure are now available, the challenge for HCV infection, and especially for HCV elimination programs, is the screening of undiagnosed HCV-infected subjects and the linkage to care, namely the availability of DAA at reasonable costs,” Alba Llibre, MD, from the Institut Pasteur, France, and colleagues wrote. “We provide proof of concept in a real-life clinical setting that the Genedrive HCV assay has great potential to provide an affordable and robust instrument for decentralized HCV [nucleic acid amplification testing (NAAT)] testing.” Read more

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