Summary
Testing and diagnosis of hepatitis C virus (HCV) infection is the gateway for access
to both treatment and prevention services, and crucial for an effective hepatitis
epidemic response. In contrast to HIV, a systematic approach to hepatitis C testing
has been fragmented and limited to a few countries, and there remains a large burden
of undiagnosed cases globally. Key challenges in the current hepatitis testing response,
include lack of simple, reliable, and low cost diagnostic tests, laboratory capacity,
and testing facilities; inadequate data to guide country-specific hepatitis testing
approaches and who to test; stigmatization and social marginalization of some groups
with or at risk of viral hepatitis; and lack of international or national guidelines
on hepatitis testing for resource-limited settings.
New tools to support the hepatitis global response include the 2016 Global Hepatitis
Health Sector Strategy which include targets for testing and diagnosis, and World
Health Organization (WHO) 2016 hepatitis testing guidelines for adults, adolescents,
and children in low- and middle-income countries. The testing guidance complements
recent published WHO guidance on the prevention, care and treatment of chronic hepatitis
C and hepatitis B infection.
These testing guidelines outline the public health approach to strengthening and expanding
current testing practices for HCV and HBV and address what serological and virological
assays to use, and who to test, as well as interventions to promote linkage to prevention
and care after testing. They are intended for use across all age groups and populations.
See boxes for key recommendations.
Future directions and innovations in viral hepatitis testing include use of point-of-care
assays for nucleic acid testing (NAT) and core antigen; validation of dried blood
spots specimens with different commercial serological and NAT assays; multiplex and
polyvalent platforms for integrated testing of HIV, HBV and HCV; and potential for
self-testing.
Keywords
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Article info
Publication history
Accepted:
August 9,
2016
Received:
August 9,
2016
Identification
Copyright
© 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
