Abstract
BackgroundSelf-testing for hepatitis C virus antibodies (HCVST) may be an additional strategy to expand access to hepatitis C virus (HCV) testing and support elimination efforts. We conducted a study to assess the usability and acceptability of HCVST among the general population in a semi-rural, high-HCV prevalence region in Egypt.MethodsAn observational study was conducted in two hospitals in the Nile Delta region. A trained provider gave an in-person demonstration on how to use the oral fluid HCVST followed by observation of the participant performing the test. Usability was assessed by observing errors made and difficulties faced by participants. Acceptability of HCV self-testing was assessed using an interviewer-administered semi-structured questionnaire.ResultsOf 116 participants enrolled, 17 (14.6%) had received no formal education. The majority (72%) of participants completed all testing steps without any assistance and interpreted the test results correctly. Agreement between participant-reported HCVST results and interpretation by a trained user was 86%, with a Cohen’s kappa of 0.6. Agreement between participant-reported HCVST results and provider-administered oral fluid HCV rapid test results was 97.2%, with a Cohen’s kappa of 0.75. The majority of participants rated the HCVST process as easy (53%) or very easy (44%), and 96% indicated they would be willing to use HCVST again and recommend it to their family and friends.ConclusionOur study demonstrates the high usability and acceptability of oral fluid HCVST in a general population. Further studies are needed to establish the optimal positioning of self-testing alongside facility-based testing to expand access to HCV diagnosis in both general and high-risk populations.
Highlights
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide
An estimated 71 million individuals are chronically infected with hepatitis C virus (HCV), and there is a disproportionately high burden of this disease in low- and middle-income countries (LMICs) [1]
We report here an assessment of the usability and acceptability of hepatitis C virus antibodies (HCVST) among the general population in a semi-rural setting in Egypt
Summary
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide. The global response to HCV has been transformed with the introduction of curative, short-course, pan-genotypic direct-acting antiviral (DAA) therapy This has led to the adoption of a “treat all” approach for HCV-infected persons, regardless of disease stage, and available at low cost in most LMICs. In 2016, the World Health Organization (WHO) launched the Global Health Sector Strategy on Hepatitis 2016–2021, with the ambitious goal to eliminate HCV as a public health threat by 2030 [2]. There has been considerable scale-up of testing and treatment in several champion countries, in particular Egypt [3]; globally, less than 20% of all persons with HCV infection have been tested and less than onequarter of diagnosed patients have been treated [1] This gap in diagnosis and treatment is even higher in many LMICs that have a high burden of HCV. We conducted a study to assess the usability and acceptability of HCVST among the general population in a semi-rural, high-HCV prevalence region in Egypt
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