Hepatitis C Virus Infection in Eastern Libya: Efforts Needed to Improve HCV Testing and Linkage to Care in the Resource-Limited Setting

Abstract

Hepatitis C virus (HCV) is a significant public health problem, and the elimination of its infection by 2031 is a global goal. However, due to insufficient testing, lack of linkage to care (LTC) and treatment, Libya may be far from achieving this goal. This study aimed to explore HCV testing, the care and treatment of infected people, and to assess the burden of the infection among individuals who visited the main Medical Centre in Tobruk region, eastern Libya, for various medical and surgical conditions. A research team interviewed public health officials in Tobruk Medical Center, inspected available equipment, and obtained data available for people who were positive for antibodies to HCV (anti-HCV) as part of their routine pre-invasive procedures and pre-donation screening tests from January 2005 to April 2020. HCV antibody tests were positive for 612 cases out of 368,392 (0.17%). Of those who tested positive for anti-HCV antibodies, no one had followed up by RNA test for identifying individuals with chronic HCV infection, and there are no links to outpatient care and treatment. Our findings highlight the critical need for an up-to-date HCV diagnosis and linkage to care guidelines, which includes a follow-up RNA test for anti-HCV positive patients and early linkage to care for confirmed cases to accelerate the elimination of HCV infection from the community.

Infection Prevention and Control: Practical and Educational Advances

“…Aula et al, extensively reviewed schistosomiasis in Africa [ 7 ], the evolution of rabies in South America during 2009–2018 was analyzed by compiling data from different sources by Meske et al [ 8 ], whereas Ioannou et al, described 12 patients with Yersinia endocarditis in a systematic review of the literature [ 9 ]. Hepatitis C (HCV) remains a significant issue in Eastern Libya according to the study by Ismail et al, where among 612 individuals who tested positive for HCV antibodies in Tobruk Medical Center from 2005 to 2020, no follow-up RNA test was detected and no links to outpatient care and treatment were found [ 10 ]. Riccò et al, detected significant gaps in knowledge and risk perceptions among 223 Italian physicians (42% were occupational physicians) in relation to hantaviruses in at-risk workers [ 11 ], whereas Laycock et al, reviewed the literature on tuberculosis among adolescents and young adults (aged 10–24 years) and identified areas for further research and interventions to prevent and treat tuberculosis in this age group [ 12 ].…”