Advances in HCV Diagnostics and Screening
Tawesak Tanwandee, MD.
Chronic hepatitis C (HCV) is among major public health thread as for 2015, it was estimated that there were about 70 million of HCV globally. The consequence of HCV leads to chronic liver disease, liver cirrhosis and hepatocellular carcinoma. Currently there is no vaccine to prevent HCV infection but availability of interferon-free direct-acting antiviral (DAAs) with high cure rate and low side effects has revolutionized the treatment. However, treatment uptake in real population was still low, as for 2017, it was calculated that just about 5 million received treatment and this is still far behind WHO ambitious goal of elimination HCV by 2030.
One can achieve this goal by changing mind set to look at the problem as public health thread, not specialist issue and make the treatment cascade simpler and more accessible to everyone as one stop service. The most important of this cascade is how to make all tests simple and become point-of-care tests. The availability of point-of-care anti-HCV test strips have allowed HCV screening much easier, cheaper and this test can be done anywhere. Moreover, revolutionized in HCV confirmation tests which include HCV antigen test and point-of-cate HCV RNA led to a truly one stop service together with pangenotypic DAAs which can skip HCV genotyping.
HCV screening can be increased by increasing awareness together with selection of target population to be screened which can be from birth cohort or target at high-risk groups and follow a simple cascade of care and reduce unnecessary step. With all this advance knowledge, we can achieve the elimination goal.