Innovations in Hepatitis C Screening and Treatment

Patel, Arpan; Bui, Anhthu Q.; Prohl, Eian G; Bhattacharya, Debika; Wang, Su; Branch, Andrea D.; Perumalswami, Ponni V.

doi:10.1002/hep4.1646

Cited by 30 publications

(59 citation statements)

References 110 publications

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Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

“…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 ].…”

Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

“…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 ].…”

Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

“…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 ].…”

Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

“…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 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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The simplification of current hepatitis C diagnostic algorithms and the emergence of digital diagnostic devices will be very crucial to achieving the WHO’s set goals of hepatitis C diagnosis (i.e., 90%) by 2030. From the last decade, hepatitis C diagnosis has been revolutionized by the advent and approval of state-of-the-art HCV diagnostic platforms which have been efficiently implemented in high-risk HCV populations in developed nations as well as in some low-to-middle income countries (LMICs) to identify millions of undiagnosed hepatitis C-infected individuals. Point-of-care (POC) rapid diagnostic tests (RDTs; POC-RDTs), RNA reflex testing, hepatitis C self-test assays, and dried blood spot (DBS) sample analysis have been proven their diagnostic worth in real-world clinical experiences both at centralized and decentralized diagnostic settings, in mass hepatitis C screening campaigns, and hard-to-reach aboriginal hepatitis C populations in remote areas. The present review article overviews the significance of current and emerging hepatitis C diagnostic packages to subvert the public health care burden of this ‘silent epidemic’ worldwide. We also highlight the challenges that remain to be met about the affordability, accessibility, and health system-related barriers to overcome while modulating the hepatitis C care cascade to adopt a ‘test and treat’ strategy for every hepatitis C-affected individual. We also elaborate some key measures and strategies in terms of policy and progress to be part of hepatitis C care plans to effectively link diagnosis to care cascade for rapid treatment uptake and, consequently, hepatitis C cure.

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Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

Section: Why Are We In Need Of Simplified Hcv Diagnostic Algorithms?mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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A Digital Case‐Finding Algorithm for Diagnosed but Untreated Hepatitis C

et al. 2021

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BaCKgRoUND aND aIMS: Although chronic HCV infection increases mortality, thousands of patients remain diagnosed-but-untreated (DBU). We aimed to (1) develop a DBU phenotyping algorithm, (2) use it to facilitate case finding and linkage to care, and (3) identify barriers to successful treatment. appRoaCH aND ReSUltS:We developed a phenotyping algorithm using Java and SQL and applied it to ~2.5 million EPIC electronic medical records (EMRs; data entered January 2003 to December 2017). Approximately 72,000 EMRs contained an HCV International Classification of Diseases code and/or diagnostic test. The algorithm classified 10,614 cases as DBU (HCV-RNA positive and alive). Its positive and negative predictive values were 88% and 97%, respectively, as determined by manual review of 500 EMRs randomly selected from the ~72,000. Navigators reviewed the charts of 6,187 algorithm-defined DBUs and they attempted to contact potential treatment candidates by phone. By June 2020, 30% (n = 1,862) had completed an HCV-related appointment. Outcomes analysis revealed that DBU patients enrolled in our care coordination program were more likely to complete treatment (72% [n = 219] vs. 54% [n = 256]; P < 0.001) and to have a verified sustained virological response (67% vs. 46%; P < 0.001) than other patients. Fortyeight percent (n = 2,992) of DBU patients could not be reached by phone, which was a major barrier to engagement. Nearly half of these patients had Fibrosis-4 scores ≥ 2.67, indicating significant fibrosis. Multivariable logistic regression showed that DBUs who could not be contacted were less likely to have private insurance than those who could (18% vs. 50%; P < 0.001). CoNClUSIoNS:The digital DBU case-finding algorithm efficiently identified potential HCV treatment candidates, freeing resources for navigation and coordination. The algorithm is portable and accelerated HCV elimination when incorporated in our comprehensive program. (Hepatology 2021;74:2974-2987). HCV infection remains a major public health threat. Highly effective direct-acting antiviral (DAA) treatments have been available

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Evaluation des Nutzens

Schlander¹,

Schäfer²,

Selberg³

2023

Nutzen Der Labormedizin in Der Schweiz

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ZusammenfassungFür jede der anhand der von ihnen verursachten Krankheitslast ausgewählten Krankheitsgruppen wird anhand mindestens eines Testverfahrens die Datenlage zum patientenbezogenen und gesellschaftlichen Nutzen der Laboratoriumsmedizin evaluiert. Der Beitrag der modernen Labormedizin erweist sich dabei in allen untersuchten Krankheitsgruppen als medizinisch „nutzenstiftend“ und vielfach sogar als unverzichtbar. Beispielhaft zu nennen sind der Einsatz prädiktiver Biomarker als Voraussetzung einer gezielten Krebstherapie, von Tests auf Anti-CCP-Antikörper beziehungsweise hochsensitives kardiales Troponin zur frühen Diagnose der rheumatoiden Arthritis bzw. des akuten Herzinfarkts, aber auch TSH-Tests für eine adäquate kausale Therapie von depressiven Störungen auf dem Boden einer Hypothyreose und therapeutisches Drug-Monitoring in der Neuropsychiatrie und darüber hinaus; schliesslich Erregerdiagnostik und Resistenzbestimmungen in der Infektiologie. Die untersuchten Tests erweisen sich zudem durchweg als kosteneffektiv.

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Innovations in Hepatitis C Screening and Treatment

Cited by 30 publications

References 110 publications

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

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

A Digital Case‐Finding Algorithm for Diagnosed but Untreated Hepatitis C

Evaluation des Nutzens

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