Rapid Diagnostics for Hepatitis B and C Viruses in Low- and Middle-Income Countries

Juliet A Shenge,Carla Osiowy

doi:10.3389/fviro.2021.742722

Juliet A Shenge, Carla Osiowy

Open Access

https://doi.org/10.3389/fviro.2021.742722

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Abstract

The global health challenge posed by hepatitis B virus (HBV) and hepatitis C virus (HCV) persists, especially in low-and-middle-income countries (LMICs), where underdiagnosis of these viral infections remains a barrier to the elimination target of 2030. HBV and HCV infections are responsible for most liver-related mortality worldwide. Infected individuals are often unaware of their condition and as a result, continue to transmit these viruses. Although conventional diagnostic tests exist, in LMIC they are largely inaccessible due to high costs or a lack of trained personnel, resulting in poor linkage to care and increased infections. Timely and accurate diagnosis is needed to achieve elimination of hepatitis B and C by the year 2030 as set out by the World Health Organization Global Health Sector Strategy. In this review rapid diagnostic tests allowing for quick and cost-effective screening and diagnosis of HBV and HCV, are discussed, as are their features, including suitability, reliability, and applicability in LMIC, particularly those within Africa.

Highlights

Elimination of viral hepatitis by 2030, as articulated in the Global Hepatitis Health Sector Strategy [1], is dependent on several factors, including increased rates of diagnoses in global communities facilitated by use of dried blood spot technology and rapid diagnostic tools, such as point-of-care (POC) assays, to increase access to testing, care and therapy [2, 3]
This review aims to describe various hepatitis B virus (HBV) and hepatitis C virus (HCV) biomarkers and the rapid diagnostic tools that are available for their detection
A similar study evaluating seven Rapid Diagnostic Tests (RDT) for detection of HCV antibodies from different risk populations among several regions in China, yielded both clinical sensitivity and specificity of 94–100%, with excellent negative predictive value (NPV) (>99.9%) among the tests evaluated; differences in HCV genotype detection were observed [53]

Summary

Introduction

Elimination of viral hepatitis by 2030, as articulated in the Global Hepatitis Health Sector Strategy [1], is dependent on several factors, including increased rates of diagnoses in global communities facilitated by use of dried blood spot technology and rapid diagnostic tools, such as point-of-care (POC) assays, to increase access to testing, care and therapy [2, 3]. Further challenges include socioeconomic inequities precluding some from accessing quality care, or the remoteness of some communities, necessitating shipping of clinical specimens to central laboratories, which can compromise specimen integrity and delay test results. These obstacles limit timely diagnosis of infection, allowing for ongoing transmission in keeping with the observed hyper-endemicity of HBV and HCV infections in LMIC [1].

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