Internet‐guided HCV‐RNA testing: A promising tool to achieve hepatitis C micro‐elimination among men who have sex with men

Abstract

In the Netherlands, hepatitis C virus (HCV) transmission occurs primarily in men who have sex with men (MSM). By early diagnosis and immediate treatment of acute HCV infections, HCV micro-elimination in MSM is within reach. In cooperation with the community affected, we developed an online HCV-RNA home-based self-sampling test service. This service combined online HCV self-risk assessment with the possibility to test anonymously for HCV-RNA. The service was available in the Netherlands from February 2018 till December 2020 and was promoted online on various dating sites and offline by community volunteers. Using website user data, test results and an online post-test user survey, we evaluated the service and user experiences. The website page with information about testing was visited by 3401 unique users, of whom 2250 used the HCV-risk assessment tool, 152 individuals purchased 194 HCV-RNA tests, and 104 tests were used, of which 101 gave a conclusive result. The target population of MSM at risk was successfully reached with 44.1% of users receiving the advice to test. The test service had a satisfactory uptake (6.8%, 152/2250), a very high HCV-RNA positivity rate (10.9%, 11/101) and was considered acceptable and easy to use by most MSM.We demonstrate that an HCV-RNA home-based self-sampling test service is successful in diagnosing HCV infections among MSM. This service could be a valuable addition to existing sexual healthcare services as it may reach men who are otherwise not tested.

Treatment as prevention effect of direct-acting antivirals on primary hepatitis C virus incidence: findings from a multinational cohort between 2010 and 2019

“…35 Decentralization of health care, peerbased or nurse-led models of care, increased testing frequency or home-based testing, incentives and simplifying the HCV cascade of care all facilitate diagnosis and treatment. [36][37][38] Crucially, we show that HCV incidence remains 10 times higher in 2019, at 50 per 100,000 PY, than the absolute incidence target of ≤5 per 100,000 PY that WHO defines as "elimination" in the general population. 4 Given that PLHIV have higher rates of HCV infection than the general population, we suggest that a PLHIV-specific absolute incidence elimination target should be considered, similar to separate targets established for PWID.…”

Hepatitis C virus reinfection incidence among gay and bisexual men with HIV in Australia from 2016 to 2020

“…In some settings, multi-component interventions including home-based HCV RNA testing and GBM-specific harm reduction supply programmes among those potentially at risk of reinfection have been studied. 25,26 In addition, behavioural interventions have been part of test and treat studies 11 or are currently underway. 27 Whether similar programs specifically for GBM in Australia would be warranted is beyond the scope of this work.…”

An online hepatitis C virus self‐sampling strategy for gay, bisexual, and other men who have sex with men and trans women: TESTATE C PLUS 2020–2021

“…Marcos Montoro-Fernandez 1 Yesika Diaz 1,5 Esteve Muntada 1 Pol Romano-deGea 1,3 Sergio Moreno-Fornés 1,5 Rubén Mora 6 Luis Villegas 6 Juan Mena 6 Quim Roqueta 7 Juanse Hernández 8 Miguel Vázquez 8 Cristina Rius 9 Francisca Román 9 Anna Not 3,4,5,10 Laura Muntané 3,4 Joan Colom 11 Jordi Casabona 1,3,5,10 Cristina Agustí…”

“…The TESTATE C PLUS study demonstrated that the provision of selfsampling kits for the detection of HCV viral infection in DBS and online consultation of results was feasible in Spain, as it was in other European countries. 8,9 The intervention enabled access to HCV testing for people at risk of HCV infection. Additionally, many of the participants had never been tested for HCV (45.04%).…”

“…A recent study in Amsterdam demonstrated that DBS self-sampling was feasible without compromising the sensitivity of HCV RNA detection and concluded that such intervention was a practical solution to improve access to testing for at-risk GBMSM. 8,9 To our knowledge, no online self-sampling intervention for screening for HCV viremic infection by viral RNA detection was performed in Spain. Might there be a need for innovative approaches to improve…”