Current challenges and possible solutions to improve access to care and treatment for hepatitis C infection in Vietnam: a systematic review

Abstract

BackgroundHepatitis C infection is a major public health concern in low- and middle-income countries where an estimated 71.1 million individuals are living with chronic infection. The World Health Organization (WHO) has recently released new guidance for hepatitis C virus (HCV) treatment programs, which include improving the access to new direct-acting antiviral agents. In Vietnam, a highly populated middle-income country, the seroprevalence of HCV infection is approximately 4% and multiple genotypes co-circulate in the general population. Here we review what is currently known regarding the epidemiology of HCV in Vietnam and outline options for reducing the significant burden of morbidity and mortality in our setting.MethodsWe performed a systematic review of the currently available literature to evaluate what has been achieved to date with efforts to control HCV infection in Vietnam.ResultsThis search retrieved few publications specific to Vietnam indicating a significant gap in baseline epidemiological and public health data. Key knowledge gaps identified included an understanding of the prevalence in specific high-risk groups, characterization of circulating HCV genotypes in the population and likely response to treatment, and the extent to which HCV treatment is available, accessed and utilized.ConclusionsWe conclude that there is an urgent need to perform up to date assessments of HCV disease burden in Vietnam, especially in high-risk groups, in whom incidence is high and cross infection with multiple genotypes is likely to be frequent. Coordinating renewed surveillance measures with forthcoming HCV treatment studies should initiate the traction required to achieve the WHO goal of eliminating HCV as a public health threat by 2030, at least in this region.

Prevalence of hepatitis B and C virus infections in hemodialysis patients in Vietnam: A systematic review and meta‐analysis

“…3 However, due to the invasive techniques associated with hemodialysis, patients are at high risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. 7,8 Although these figures may be underestimated due to the limited data currently available, they are high compared to other countries in the region. 7,8 Although these figures may be underestimated due to the limited data currently available, they are high compared to other countries in the region.…”

“…[4][5][6] In Vietnam, the seroprevalences of HBV and HCV infections in the general community are approximately 10 and 4%, respectively. 7,8 In Vietnam, the first hemodialysis for ESRD patients was conducted at tertiary hospitals in 1983. 7,8 In Vietnam, the first hemodialysis for ESRD patients was conducted at tertiary hospitals in 1983.…”

Confirmation of HCV viremia using HCV RNA and core antigen testing on dried blood spot in HIV infected peoples who inject drugs in Vietnam

“…In Vietnam, the presence of anti-HCV antibodies has been reported between 1 to 6% of the general population and is dramatically higher (up to 90%) in people who inject drugs [ 8 , 9 ]. The Vietnamese Ministry of Health has recently developed a national HCV guidance upon the release of the first WHO Guidelines on HCV care and treatment [ 10 ].…”

The direct-medical costs associated with interferon-based treatment for Hepatitis C in Vietnam

“…Vietnam is a lower-middle-income country in Southeast Asia with a population of over 95 million people 17 , and a 2017 GDP per capita of US$2365 18 . The seroprevalence of HCV in the general population has been estimated to be between 1 and 4.7% 19 , 20 , which is high relative to other countries in the region. In Vietnam, genotypes 1 and 6 predominate 19 , 21 .…”