Abstract
Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n) = 14; pooled relative risk (RR) 1.7, 95 % CI 1.3, 2.2] and patients commencing therapy (n = 4; RR 3.3, 95 % CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (n = 12; RR 3.5, 95 % CI 2.5, 4.8; and n = 10; RR 2.2, 95 % CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (n = 4; RR 1.5, 95 % CI 0.7, 3.0; and n = 4; RR 1.3, 95 % CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour.Electronic supplementary materialThe online version of this article (doi:10.1007/s10654-014-9958-4) contains supplementary material, which is available to authorized users.
Highlights
It is estimated that 185 million people have been infected with hepatitis C virus (HCV) worldwide [1], most of whom are unaware of their infection [2]
This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liverrelated morbidity
Populations at increased risk of HCV include people who inject drugs (PWID) [5], people receiving medical procedures in an unsafe setting [6, 7], men who have sex with men (MSM) [8], and children born to mothers who have HCV [9]
Summary
It is estimated that 185 million people have been infected with hepatitis C virus (HCV) worldwide [1], most of whom are unaware of their infection [2]. The burden is highest in low- and middle-income countries (LMIC), which account for over 80 % of cases of chronic HCV infection [1]. People living with HCV may experience considerable barriers to accessing testing, treatment and care, in low-income countries [3, 4]. Populations at increased risk of HCV include people who inject drugs (PWID) [5], people receiving medical procedures (including transfusion of blood and blood products) in an unsafe setting [6, 7], men who have sex with men (MSM) (in particular, those who are infected with HIV) [8], and children born to mothers who have HCV [9]. Intranasal drug use and cosmetic procedures (such as tattooing, body piercing, and manicures) have been implicated as risk factors for HCV [10]. The relative importance of these risk factors varies depending on the geographical setting and population studied
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
