Diagnosis Of Hepatitis C Virus Infection Research Articles

No association between hepatitis C virus infection and risk of colorectal cancer: a systematic review and meta-analysis of cohort studies.

There is still uncertainty regarding whether hepatitis C virus (HCV) infection is associated with colorectal cancer (CRC). This study aims to investigate the potential association between HCV infection and CRC through a systematic review and meta-analysis of cohort studies. PubMed, Embase, and Web of Science were systematically searched from the beginning of their inception to October 2023 to find relevant cohort studies on the association between HCV infection and CRC risk. The random-effect, generic inverse variance method was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for CRC outcome among individuals with HCV infection. We also performed subgroup and sensitivity analysis. A total of 8 cohort studies involving 1,939,164 participants were included in this meta-analysis. The result from the meta-analysis suggested that there was no statistically significant association between HCV and the risk of developing CRC (HR = 0.99, 95% CI: 0.82-1.88, p = 0.88) with low statistical heterogeneity (I2 = 28%, p = 0.20). Subgroup analyses that were conducted based on study design, diagnosis of HCV infection, and publication year yielded similar results. Analyses of subgroups based on study areas revealed that there was no significant association between HCV infection and CRC risk in Asia (n = 2, HR = 0.96, 95% CI: 0.71-1.29, p = 0.79; I2 = 26%), Europe (n = 3, HR = 1.06, 95% CI: 0.83-1.37, p = 0.63; I2 = 0%), and North America (n = 2, HR = 1.10, 95% CI: 0.87-1.38, p = 0.44; I2 = 0%); however, a negative correlation was found in Oceania (n = 1, HR = 0.43, 95% CI: 0.22-0.84, p = 0.01). Sensitivity analysis further reinforce the stability of our conclusion. Our cohort-based meta-analysis showed insufficient evidence to support the association between HCV infection and an increased risk of CRC. To gain a clearer insight into the potential association between these two conditions, it would be beneficial to conduct large, well-designed, high-quality prospective cohort studies that consider different ethnic populations and potential confounding factors.Systematic review registration: PROSPERO, identifier [CRD42023472688], https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023472688.

The best anti-HCV S/Co values for reflecting HCV infection in a university hospital in the eastern part of Turkey.

The measurement of hepatitis C virus (HCV) RNA is a test that requires high cost, advanced technique, and qualified personnel. Diagnosis and treatment of patients may be delayed due to the high rate of false-positive results. This study aims to predict true antibody positivity and viremia by determining the most appropriate anti-HCV signal-to-cutoff (S/Co) value reflecting HCV infection. The presence of anti-HCV antibodies and HCV RNA levels were examined in 72341 people who applied to the Mengücek Gazi Training and Research Hospital between January 2018 and December 2020. The anti-HCV levels were determined by using the Abbot Architect i2000 SR device (Abbot Diagnostics, Chicago, IL, USA). The levels of HCV RNA were determined in the COBAS AmpliPrep/COBAS, TaqMan 48 (Roche, Diagnostics, Pleasanton, USA) devices using serum samples from patients. Our study is a retrospective and methodological study. Of the 150 patients with anti-HCV antibodies, 50 (33.3%) were HCV RNA positive, and 100 (66.7%) were HCV RNA negative. Anti-HCV levels of HCV RNA-positive patients were statistically higher than HCV RNA-negative patients. The most appropriate anti-HCV S/Co value for diagnosing hepatitis C patients was 15.4. The sensitivity of this value was 72%, specificity 88%, positive predictive value (PPV) 73.5%, and negative predictive value (NPV) 86.1%. Receiver operating characteristic (ROC) curve was significantly higher than 0.5 (95% confidence interval 0.938-0.827). Correct approaches can be applied in the diagnosis of HCV infection using the anti-HCV S/Co value found in our study.

Comparison of effectiveness and cost of different HCV testing strategies in high-risk populations in China.

High-risk populations are the predominant populations affected by hepatitis C virus(HCV) infection, and there is an urgent need for efficient and cost-effective HCV testing strategies for high-risk populations to identify potential undiagnosed HCV-infectedindividuals. This study compared several commonly used testing strategies and conducted effectiveness and cost analysis to select the appropriate testing strategy for diagnosing HCV infection in high-risk populations. Among the 2093 samples from high-risk populations in this study, 1716 were HCV negative, 237 were current HCV infection, 137 were past HCV infection, and three were acute early HCV infection. It was found that out of 237 patients with HCV current infection, Strategy A could detect 225 cases, with a missed detection rate of 5.06%, and the total cost was 33 299 RMB. In addition, Strategy B could detect 237 cases of current HCV infection, and the HCV missed detection rate was 0.00%, and the total cost was 147 221 RMB. While 137 cases of past HCV infection could be distinguished by strategy C, but 14 cases with current HCV infection were missed, with an HCV-positivemissed detection rate of 5.91%, and the total cost for Strategy C was 43 059 RMB. In conclusion, in high-risk populations, the HCV positivity rate is typically higher. If feasible, the preferred approach is to directly conduct HCV RNA testing, which effectively minimizes the risk of missing cases. However, in situations with limited resources, it is advisable to initially choose a highly sensitive method for anti-HCV screening, followed by HCV RNA testing on reactive samples.

Development of simple, rapid, and sensitive methods for detection of hepatitis C virus RNA from whole blood using reverse transcription loop-mediated isothermal amplification.

Hepatitis C virus (HCV) infection is an underdiagnosed global health problem. Diagnosis of current HCV infections typically requires testing for HCV RNA using high-complexity laboratory tests. Methods for the detection of HCV RNA that are simple, inexpensive, rapid, and compatible with use outside of a laboratory setting are very important in order to improve access to hepatitis C diagnostic testing and facilitate accelerated linkage to care. We developed and evaluated three simple workflows for extracting HCV RNA from small volumes of whole blood for use in a sensitive, pan-genotypic RT-LAMP assay. The water workflow uses osmotic stress to release HCV RNA and has a limit of detection of 4.3 log10(IU/mL) (95% CI 4.0-4.9). The heat workflow uses a heating step to release HCV RNA and has a limit of detection of 4.2 log10(IU/mL) (95% CI 3.8-5.1). The bead workflow, which uses chemical lysis of the sample and a streamlined paramagnetic solid phase reversible immobilization bead procedure for nucleic acid purification, has a limit of detection of 2.8 log10(IU/mL) (95% CI 2.5-3.4). When used to test whole blood spiked with HCV RNA-positive plasma samples in which most HCV levels were below 5.0 log10(IU/mL), the water, heat, and bead workflows detected HCV RNA in 69%, 75%, and 94% of samples, respectively. These workflows are compatible with visual lateral flow dipsticks, and each takes less than 60 min from sample to result. Each workflow can be performed with minimal and inexpensive equipment. With further procedural simplifications, these workflows may form the basis of assays for the point-of-care diagnosis of HCV infections.

Trends in Hepatitis C Virus and HIV Care Outcomes Among People With HIV in Georgia, United States, 2014-2019.

If untreated, hepatitis C virus (HCV) leads to poor health outcomes, including liver disease and death, particularly among people with HIV (PWH). We describe trends over time in incidence rates of HCV diagnoses among PWH in the state of Georgia. We constructed a retrospective cohort of PWH in Georgia by using matched HIV and HCV case surveillance data from people diagnosed with HCV infection from January 1, 2014, through December 31, 2019. We calculated annual incidence rates per 1000 person-years and estimated trends over time in HCV diagnoses among the cohort of PWH by demographic characteristics and HIV care outcomes using Poisson regression analysis, with α = .05 considered significant. From 2014 through 2019, among 49 530 PWH in Georgia, 1945 (3.9%) were diagnosed with HCV infection. During this period, overall incidence per 1000 person-years of newly diagnosed HCV infection among PWH decreased from 8.7 to 4.5 (P for trend < .001). However, from 2014 through 2019, the annual incidence rates of PWH who were newly diagnosed with HCV infection increased from 4.6 to 7.1 (P for trend = .003) among people born from 1980 through 1989 and from 3.3 to 12.8 (P for trend < .001) among people born in 1990 or later. Strategies are needed to increase prevention, diagnosis, and treatment of HIV/HCV coinfection, particularly among PWH born in 1980 and later. Routine linkage of state surveillance data can inform prioritization of PWH at highest risk of HCV infection.

Molecular Point-of-Care Testing for Hepatitis C: Available Technologies, Pipeline, and Promising Future Directions.

Hepatitis C virus (HCV) remains a major public health problem, despite the availability of effective treatments. In many areas, the ability to diagnose HCV infection at the point of care is key to scaling up access to care and treatment. To achieve this, an accurate, easy-to-use, and affordable diagnostic tool is required-this would enable decentralized testing and the creation of one-stop centers to eliminate gaps in the care cascade, which would help reach the millions of people with undiagnosed HCV infection in low- and middle-income countries and high-risk populations in high-income countries. In this review, we examine the current state of point-of-care molecular technologies, the advantages and limitations of currently available devices (both near- and true-point-of-care), the potential of molecular testing to transform diagnostic medicine in the future, and the challenges that need to be addressed for broader adoption of this technology in routine clinical practice.

Community-Based Point-of-Diagnosis Hepatitis C Treatment for Marginalized Populations

Disparities persist in testing and treatment for hepatitis C virus (HCV), leaving socially marginalized populations less likely to benefit from curative treatment. Linkage services are often insufficient to overcome barriers to navigating the medical system and contextual factors. To determine the feasibility, acceptability, and safety of HCV treatment at the point of HCV infection diagnosis disclosure in a nonclinical community setting. In this single-arm nonrandomized controlled trial conducted between July 1, 2020, and October 31, 2021, street-outreach recruitment targeted people experiencing homelessness and injecting drugs in an urban US community who were eligible for simplified HCV treatment. Study procedures were designed to reflect the community environment and services needed to provide HCV testing, disclosure, and treatment in a nonclinical site. The test-and-treat No One Waits (NOW) model of care provided a 2-week starter pack of 400 mg of sofosbuvir and 100 mg of velpatasvir at time of HCV RNA results disclosure. Participants were transitioned to insurance-provided sofosbuvir-velpatasvir when feasible to complete a 12-week treatment course. The primary end point was sustained virologic response at posttreatment week 12 or later (SVR12). Acceptability end points were treatment initiation and completion. Safety end points were treatment discontinuation because of a late exclusion criterion and adverse events. Of the 492 people (median [IQR] age, 48 [37-58] years; 62 [71%] male) who underwent anti-HCV testing, 246 (50%) tested anti-HCV positive, and 111 (23%) tested HCV RNA positive and were eligible for simplified HCV treatment. Eighty-nine of the 111 eligible participants (80%) returned for confirmatory RNA results, and 87 (98%) accepted and initiated HCV treatment. Seventy (80%) were currently injecting drugs, 83 (97%) had an income below the poverty line, and 53 (61%) were currently unsheltered. Most had HCV genotype 1a (45 [52%]) or 3 (20 [23%]). Sixty-nine (79%) completed 12 weeks of sofosbuvir-velpatasvir treatment, 2 stopped treatment because of low adherence, and 16 were lost to follow-up. Of the 66 participants who completed treatment and had a successful blood draw, 61 (92%) had undetectable HCV RNA at treatment completion. Of the 87 treated patients, 58 achieved SVR12, leading to a treatment response of 67% (95% CI, 56%-76%) among the intention-to-treat group and 84% (95% CI, 73%-92%) among the per-protocol group. There were no adverse events, late exclusions, or deaths. In this nonrandomized controlled trial of HCV treatment at the point of diagnosis, the NOW model of care reduced steps between HCV testing and treatment initiation and resulted in high levels of treatment initiation, completion, and cure. The NOW model of care can expand the current HCV test-and-treat toolkit by reaching a broader population of marginalized communities and expediting curative therapy. ClinicalTrials.gov Identifier: NCT03987503.

Tools Needed to Support Same-Day Diagnosis and Treatment of Current Hepatitis C Virus Infection.

The current multiday diagnosis and treatment paradigm for hepatitis C virus (HCV) infection results in far fewer patients receiving treatment with direct-acting antiviral agents than those with diagnosed HCV infection. To achieve HCV elimination, a paradigm shift in access to HCV treatment is needed from multiday testing and treatment algorithms to same-day diagnosis and treatment. This shift will require new tools, such as point-of-care (POC) antigen tests or nucleic acid tests for HCV and hepatitis B virus (HBV) and nucleic acid tests for human immunodeficiency virus (HIV) that do not require venous blood. This shift will also require better use of existing resources, including expanded access to HCV treatment and available POC tests, novel monitoring approaches, and removal of barriers to approval. A same-day diagnosis and treatment paradigm will substantially contribute to HCV elimination by improving HCV treatment rates and expanding access to treatment in settings where patients have brief encounters with healthcare.

Core indicators related to the elimination of hepatitis B and C virus infection in South Korea: A nationwide study.

To eliminate hepatitis B virus (HBV) and hepatitis C virus (HCV) according to the World Health Organization (WHO) criteria in 2021, this study investigated the national core indicators representing the current status of viral hepatitis B and C in South Korea. We analyzed the incidence, linkage-to-care, treatment, and mortality rates of HBV and HCV infection using the integrated nationwide big data of South Korea. According to data from 2018-2020, the incidence of acute HBV infection in South Korea was 0.71 cases per 100,000 population; tthe linkage-to-care rate was only 39.4%. Among those who need hepatitis B treatment, the treatment rate was 67.3%, which was less than 80% reported in the WHO program index. The annual liver-related mortality due to HBV was 18.85 cases per 100,000 population, exceeding the WHO target of four; the most frequent cause of death was liver cancer (54.1%). The annual incidence of newly diagnosed HCV infection was 11.9 cases per 100,000 population, which was higher than the WHO impact target of five. Among HCV-infected patients, the linkage-to-care rate was 65.5% while the treatment rate was 56.8%, which were below the targets of 90% and 80%, respectively. The liver-related annual mortality rate due to HCV infection was 2.02 cases per 100,000 population. Many of the current indicators identified in the Korean population did not satisfy the WHO criteria for validation of viral hepatitis elimination. Hence, a comprehensive national strategy should be urgently developed with continuous monitoring of the targets in South Korea.

Evaluation of the Correlation of HCV Core Antigen Levels with HCV RNA Levels in the Diagnosis and Treatment Follow-up of Hepatitis C Virus Infections

Hepatitis C virus (HCV) infections are an important public health issue across the world because of the high risk of chronicity potential, impossibility of protection by vaccination and serious complications such as hepatocellular carcinoma. The aim of this study was to evaluate the correlation of HCV core antigen test with HCV RNA in the diagnosis and treatment follow-up and to discuss the status of being an alternative test in routine use. In the first step of the study, the compatibility of the methods was investigated by applying the HCV core antigen test to 600 serum samples from patients with pre diagnosis of HCV infection for whom anti-HCV and HCV RNA tests were routinely studied in the molecular microbiology laboratory of medical microbiology department between December 2016 and December 2018. In the second step, in addition to the routine HCV RNA test, HCV core antigen test was studied in serum samples taken before the start of the treatment, at the eighth week of the treatment and at the end of the treatment of 150 patients whose treatment were decided by the gastroenterology department within this period. The correlation between the two tests was evaluated during the treatment follow-up. Forty-nine of 600 patients were diagnosed according to test results. In 28 patients, HCV core antigen was positive in addition to HCV RNA and anti-HCV which were routinely studied. The sensitivity of HCV core antigen test was 91.49%, specificity was 100%, PPD was 100%, NPD was 97.30%, accuracy was 87.76%. There was a high correlation between HCV RNA and HCV core antigen results. In the second step of the study, sensitivity (96.52%), specificity (95.28%), PPD (95.11%), NPD (95.80%) and accuracy (92.58%) of the HCV core antigen test were determined. These results show that there is a high correlation between the two tests and that HCV core antigen test can be used as an alternative test to HCV RNA test as it is an easily applicable and cost effective test during diagnosis and treatment follow-up.

Deliveries Among Patients With Maternal Hepatitis C Virus Infection in the United States, 2000-2019.

To assess clinical characteristics, trends, and outcomes associated with the diagnosis of hepatitis C virus (HCV) infection during pregnancy. This cross-sectional study analyzed delivery hospitalizations using the National Inpatient Sample. Temporal trends in both diagnosis of HCV infection and clinical characteristics associated with HCV infection were analyzed using joinpoint regression to estimate the average annual percent change (AAPC) with 95% CIs. Survey-adjusted logistic regression models were fit to assess the association among HCV infection and preterm delivery, cesarean delivery, and severe maternal morbidity (SMM), adjusting for clinical, medical, and hospital factors with adjusted odds ratios (aORs) as the measure of association. An estimated 76.7 million delivery hospitalizations were included, in which 182,904 (0.24%) delivering individuals had a diagnosis of HCV infection. The prevalence of HCV infection diagnosed in pregnancy increased nearly 10-fold over the study period, from 0.05% in 2000 to 0.49% in 2019, representing an AAPC of 12.5% (95% CI 10.4-14.8%). The prevalence of clinical characteristics associated with HCV infection also increased over the study period, including opioid use disorder (from 10 cases/10,000 birth hospitalizations to 71 cases/10,000 birth hospitalizations), nonopioid substance use disorder (from 71 cases/10,000 birth hospitalizations to 217 cases/10,000 birth hospitalizations), mental health conditions (from 219 cases/10,000 birth hospitalizations to 1,117 cases/10,000), and tobacco use (from 61 cases/10,000 birth hospitalizations to 842 cases/10,000). The rate of deliveries among patients with two or more clinical characteristics associated with HCV infection increased from 26 cases per 10,000 birth hospitalizations to 377 cases per 10,000 delivery hospitalizations (AAPC 13.4%, 95% CI 12.1-14.8%). In adjusted analyses, HCV infection was associated with increased risk for SMM (aOR 1.78, 95% CI 1.61-1.96), preterm birth (aOR 1.88, 95% CI 1.8-1.95), and cesarean delivery (aOR 1.27, 95% CI 1.23-1.31). Diagnosis of HCV infection is increasingly common in the obstetric population, which may reflect an increase in screening or a true increase in prevalence. The increase in HCV infection diagnoses occurred in the setting of many baseline clinical characteristics that are associated with HCV infection becoming more common.

Diagnostic performance of hepatitis C core antigen assay to identify active infections: A systematic review and meta-analysis.

Hepatitis C virus (HCV) core antigen (HCVcAg) assay is an alternative for diagnosing HCV infection in a single step. This meta-analysis aimed to evaluate the Abbott ARCHITECT HCV Ag assay's diagnostic performance (validity and utility) for diagnosing active hepatitis C. PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library were searched until 10 January 2023. The protocol was registered at the prospective international register of systematic reviews (PROSPERO: CRD42022337191). Abbott ARCHITECT HCV Ag assay was the test for evaluation, and nucleic acid amplification tests with a cut-off ≤50IU/mL were the gold standard. Statistical analysis was performed using STATA with the MIDAS module and random-effects models. The bivariate analysis was conducted on 46 studies (18,116 samples). The pooled sensitivity was 0.96 (95% CI=0.94-0.97), specificity 0.99 (95% CI=0.99-1.00), positive likelihood ratio 141.81 (95% CI=72.39-277.79), and negative likelihood ratio 0.04 (95% CI=0.03-0.06). The area under the summary receiver operating characteristic curve was 1.00 (95% CI=0.34-1.00). For active hepatitis C prevalence values of 0.1%-15%, the probability that a positive test was a true positive was 12%-96%, respectively, indicating that a confirmatory test should be necessary, particularly with a prevalence ≤5%. However, the probability that a negative test was a false negative was close to zero, indicating the absence of HCV infection. The validity (accuracy) of the Abbott ARCHITECT HCV Ag assay for screening active HCV infection in serum/plasma samples was excellent. Although the HCVcAg assay showed limited diagnostic utility in low prevalence settings (≤1%), it might help diagnose hepatitis C in high prevalence scenarios (≥5%).

Gold-aptamer modified dielectrode silica surface for hepatitis C virus core antigen sandwich assay

Hepatitis C virus (HCV) cause both chronic and acute hepatitis, depends on the severity from mild to serious illness, leads a lifelong illness, such as liver cancer and liver cirrhosis. Chronic HCV is generally a silent infection for several years, until it damages the liver. Diagnosing HCV infection in a regular basis is mandatory and this research focused to quantify hepatitis C-core antigen (HCVcoreAg) on aptamer-gold modified dielectrode silica surface. Aptamer-biotin was immobilized on the electrode by using streptavidin-gold nanoparticle interaction, which enhance the number of aptamer attachment on interdigitated dielectrode (IDE). Further, aptamer-antibody sandwich assay was carried out to increase the analytical performance for HCVcoreAg detection and reached a limit of detection to 0.5 pg/mL on a linear increment range from 0.5 to 16 pg/mL with an acceptable regression coefficient [y = 1.0116×−1.372; R2 = 0.963]. In addition, blocking agent PEG-b-PAAc reduced the biofouling on IDE and control the increment of current responses in non-specific experiments, which helps to detect the HCVcoreAg in mixed biological samples without interferences. This sandwich assay detects the lower level of HCVcoreAg and diagnose HCV infection.

Annual trends of hepatitis C virus infection in Manitoba between 1998 and 2018: A focus on special populations.

Hepatitis C virus (HCV) infection is a major cause of liver-related morbidity and mortality worldwide. Epidemiological data of HCV infection in the Canadian province of Manitoba are limited. A population-based retrospective study was conducted using data from the Manitoba Centre for Health Policy repository. Using the test results provided by the Cadham provincial laboratory, individuals in Manitoba with a diagnosis of HCV infection were identified. Annual prevalence and incidence rates (crude and standardized) were calculated for the overall population and stratified by sex, regional health authority (RHA), residence area, income quintile, and special population groups (children, older adults, and pregnant persons). A total of 8,721 HCV cases were diagnosed between 1998 and 2018 in Manitoba. Overall crude HCV incidence and prevalence were estimated as 0.03% and 0.37% during the study period, respectively. No significant change was observed in the standardized HCV incidence rate (per 100,000) during the study period (54.3 in 1998 and 54.8 in 2018). However, the standardized HCV prevalence (per 100,000) increased from 52.5 (95% CI 39.2-68.7) in 1998 to 655.2 (95% CI 605.9-707.3) in 2018. An overall average incidence rate based on sex, RHA, region, income, and special population groups was observed to be higher in males (40.1), Winnipeg RHA (42.7), urban region (42.3), low-income quintiles (78.5), and pregnant persons (94.3), respectively. Although incidence rates of HCV infection in Manitoba appeared to have initially declined, rates showed an upward trend by the end of the study period while prevalence increased steadily.

Prevalence of Hepatitis C Virus Among Pregnant Women at Tertiary Care Hospital

Backgrounds: The prevalence study of HCV infection among pregnant women is limited in central India. Vertical transmission (Mother-to-child) has become the major cause of pediatric hepatitis C virus (HCV) infection. Thus, the present study aimed to evaluate the prevalence of hepatitis C among pregnant females attending antenatal clinics. Material and Methods: The cross-sectional study done at Malwanchal University, Indore Madhya Pradesh, from March 2019 to September 2022. The confirm diagnosis of HCV infection made by anti-HCV Enzyme-linked immunosorbent assay (ELISA) among enrolled pregnant women. Results: Out of 3254 pregnant women tested, 26 were found positive for HCV infection. The prevalence of 0.79% was observed. The majority of infection were found in age groups 21-25 years 11/26 (42.3%) and in 26-30 years 09/26 (34.6%). The study also concluded to the most positive pregnant women belonged to low-income groups and rural areas. Conclusion: Screening of pregnant women during each pregnancy, and testing infants born to mothers with HCV infection highly recommend to for the timely prevention of its transmission to infants. Keywords: Vertical transmission, pregnant women, HCV infection

The Hepatitis C Care Cascade During the Direct-Acting Antiviral Era in a United States Commercially Insured Population.

BackgroundPeriodic surveillance of the hepatitis C virus (HCV) care cascade is important for tracking progress toward HCV elimination goals, identifying gaps in care, and prioritizing resource allocation. In the pre-direct-acting antiviral (DAA) era, it was estimated that 50% of HCV-infected individuals were diagnosed and that 16% had been prescribed interferon-based therapy. Since then, few studies utilizing nationally representative data from the DAA era have been conducted in the United States.MethodsWe performed a cross-sectional study to describe the HCV care cascade in the United States using the Optum de-identified Clinformatics® Data Mart Database to identify a nationally representative sample of commercially insured beneficiaries between January 1, 2014 and December 31, 2019. We estimated the number of HCV-viremic individuals in Optum based on national HCV prevalence estimates and determined the proportion who had: (1) recorded diagnosis of HCV infection, (2) recorded HCV diagnosis and underwent HCV RNA testing, (3) DAA treatment dispensed, and (4) assessment for cure.ResultsAmong 120,311 individuals estimated to have HCV viremia in Optum during the study period, 109,233 (90.8%; 95% CI, 90.6%–91.0%) had a recorded diagnosis of HCV infection, 75,549 (62.8%; 95% CI, 62.5%–63.1%) had a recorded diagnosis of HCV infection and underwent HCV RNA testing, 41,102 (34.2%; 95% CI, 33.9%–34.4%) were dispensed DAA treatment, and 25,760 (21.4%; 95% CI, 21.2%–21.6%) were assessed for cure.ConclusionsGaps remain between the delivery of HCV-related care and national treatment goals among commercially insured adults. Efforts are needed to increase HCV treatment among people diagnosed with chronic HCV infection to achieve national elimination goals.

Hepatitis C Virus: What You Need to Know

Anyone can get infected with hepatitis C virus (HCV), the virus that causes hepatitis C. Hepatitis C is a liver infection that can lead to serious liver problems and possibly death.Although most children and adolescents recover from the initial phase of HCV infection, 70% to 80% of acute infections become chronic. Here is information from the American Academy of Pediatrics about HCV symptoms, how HCV is spread, and ways to reduce the risk of an HCV infection.People infected with HCV may have no or mild symptoms at first. People who have symptoms may experience one or more of the following:Many babies and children show no symptoms. Some babies with HCV infection may have an enlarged liver or spleen, grow more slowly, or fail to gain weight.If your child has some of the symptoms of HCV infection, contact your child’s doctor. Let your child’s doctor know if your child has been exposed to anyone with HCV. To diagnose HCV infection, your child’s doctor will examine your child and test your child’s blood for the virus.Hepatitis C virus cannot be spread by touching, hugging, or kissing. Children with HCV infection can participate in all normal childhood activities and should not be excluded from child care centers or schools.Hepatitis C virus can be spread through contact with blood or at childbirth. Hepatitis C virus can also be spread through sharing needles.Most babies acquire HCV at birth from a mother who has HCV infection. The risk of acquiring infection is about 1 in 20 for a baby born to a mother with HCV infection.There currently is no vaccine for HCV infection. However, to reduce the risk of getting an HCV infection through contact with blood, do not share household items such as toothbrushes, razors, nail clippers, or other items that may contain small amounts of blood.Also, because HCV can be spread through sexual contact, teens and adults with HCV infection should be strongly advised to avoid having sex. If they are going to have sex, they need to use latex condoms to prevent the spread of HCV. Anyone with HCV infection should also avoid drinking alcohol because alcohol can speed up liver damage.In some children, HCV infection can lead to persistent liver disease in the form of cirrhosis or scarring of the liver. Cirrhosis occurs when the liver cells die and are replaced by scar tissue and fat. Over time, the liver stops working and can no longer remove wastes from the body. Infants who develop cirrhosis of the liver because of chronic HCV infection may need a liver transplant to survive. Children infected with HCV also are at risk for developing other serious liver diseases, including liver cancer.There are new drugs that can cure HCV infection in 95% to 98% of children 3 years and older.American Academy of Pediatricswww.aap.org and www.HealthyChildren.orgThe American Academy of Pediatrics (AAP) is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Comparison Of Hepatitis C Antibody Assays And Evaluation Of Agreement Between Hepatitis C Antigen And PCR Results.

Hepatitis C is associated with a wide range of health repercussions. Pakistan is one of the highly prevalent countries of Hepatitis C Virus (HCV) infection. The availability of cost-effective, robust, and reliable screening and diagnostic tests for hepatitis C is important to address the disease burden. Standardization of screening and diagnostic assays in clinical laboratories is crucial for achieving big goals. Objectives of this study are to correlate the results of two different HCV antibody (HCV Ab) assays and to examine the correlation of HCV core antigen (HCV c Ag) results with HCV PCR for HCV infection diagnosis. This descriptive cross-sectional study was carried out from November to December 2020 at Dow University of Health Sciences. Total number of 40 HCV Ab samples were analysed by both chemiluminescence (CMIA) and electrochemiluminescence (ECLIA) immunoassays. Tests for HCV RNA PCR and HCV c Ag were performed on all samples. Results of screening and diagnostic assays were correlated and agreements were examined. Statistical analysis for agreement was carried out by using R software version 3.6.3 through AC1 Gwetz Statistic. The study was approved by the institutional ethical review committee. An agreement of 0.73 and 0.95 was found between two different HCV Ab immunoassays and HCV c Ag and HCV PCR, respectively. We found a good correlation between CMIA and ECLIA for HCV Ab. An excellent correlation was found between HCV c Ag and HCV PCR. Based on our study findings, HCV c Ag is a candidate test for the diagnosis of active HCV infection.

Misunderstanding of hepatitis C virus (HCV) infection status by non–specialized medical doctors in patients who achieved sustained virologic response to anti-HCV therapy

IntroductionWith the increase in the number of patients with sustained virologic response (SVR) in whom hepatitis C virus (HCV) was eradicated by the anti-HCV therapy, there are now many individuals in whom serum HCV RNA is absent despite positive serum HCV antibodies. However, in general clinical practice, HCV infection remains usually screened by measurement of serum HCV antibodies and patients with SVR can be misunderstood regarding HCV infection status. MethodsIn the multicenter study, we conducted interviews with administered questionnaires to SVR individuals who had regular hospital visits after SVR. The prevalence of experiencing an incorrect diagnosis of HCV infection after SVR was assessed. Individuals who experienced this misunderstanding were further asked where they experienced it and how it made them feel. ResultsIn a survey of 2,246 SVR individuals, 197 individuals (8.8%) were misunderstood as having persistent HCV infection by medical doctors due to positive HCV antibody, despite the absence of HCV viremia. These misunderstandings occurred most prevalently at a private clinic (55.3%). More than half (53.3%) of these individuals felt anxious about their HCV infection with becoming unsure about their HCV eradication status. ConclusionsMisunderstanding HCV status is commonly occurred in SVR individuals. Specialists in hepatology and infectious diseases should broadly emphasize the fact that most patients with HCV antibodies are now HCV-free because of the use of anti-HCV therapy.

An Easy-to-Implement Risk Score for Targeted Hepatitis C Virus Testing in the General Population.

ABSTRACTDespite the effectiveness of available treatments, hepatitis C virus (HCV) remains a major public health problem, mainly due to the high percentage of undiagnosed individuals. We aim to create an easy-to-implement risk score to facilitate targeted HCV testing in the general population. This is a substudy derived from a prospective study in primary care in Madrid (Spain). Participants completed a 21-question risk assessment questionnaire, followed by HCV testing for those with at least one positive response and those >50 years of age, even if they did not answer positively. We used the population >50 years of age to fit a logistic regression model to create a score predicting the risk of a positive test result. We then performed a sensitivity analysis by applying the score obtained to the population <50 years of age, to assess its diagnostic accuracy. Data collected from 2,302 participants were included in the analysis. The prevalence of HCV infection was 1.3%. Five items were selected, showing a C-statistic of 0.896, i.e., male sex, Eastern European origin, use of intravenous drugs, self-perceived risk of acquired HCV infection, and past hepatitis or unexplained liver disease. The sensitivity was 98%, and the negative likelihood ratio was 0.05 for participants with scores of 0 (49.8% in our sample), ruling out HCV infection with high probability. We obtained similar estimates in the population <50 years of age. This tool achieved high diagnostic accuracy to target HCV testing. This could help optimize resources when universal screening is not feasible.IMPORTANCE Despite the highly effective treatments currently available, HCV remains one of the major public health problems related to an infectious agent, mainly because a high percentage of individuals remain undiagnosed. Universal screening has been proposed as a way to end this epidemic; however, it is not feasible in all settings due to different implementation barriers. With this work, we aim to collaborate in improving the diagnosis of HCV infection by creating a simple 5-item score that rules out HCV infection with a very high probability. Almost one-half of the participants in our sample did not present any affirmative answers to these questions, and their probability of being infected was close to 0%. This tool could be a useful strategy and could be considered a cost-effective alternative to optimize resources when universal screening is not feasible.