Prevalence-based screening by anti-HCV reflex HCV antigen test and accessible post-screening care towards elimination of hepatitis C in rural villages.
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Abstract
Background: One major barrier to the goals of hepatitis C virus (HCV) elimination is identification and linkage-to-care for those with HCV infection. The aim of this research was to develop a strategy to help achieve HCV elimination in remote rural villages.
Methods: According to the maps of the township- and village-specific testing rates and prevalence rates of anti-HCV produced by the Public Health Bureau of Yunlin County, a high anti-HCV prevalent township Sihhu and four nearby villages were selected for an intensive screening with anti-HCV reflex HCV antigen test. A temporary outreach hepatology clinic was set in Sihhu Township Health Center to enhance accessibility for post-screening care of those positive for HCV antigen.
Results: The population aged ≥ 40 years of the included villages at time of survey was 18,018 with 5,343 (29.7%, range 18.8-39.7%) having ever been previously screened, and 1,503 responded to this screening. The crude screening coverage rate increased to 38.0% (range 27.6-47.2%) after this screening campaign. The prevalence rates of anti-HCV and HCV antigen were 17.3% and 8.3% respectively, with the rate of antigenemia (HCV antigen/anti-HCV) being 48.1%. The number needed to test (NNT) to find a candidate for anti-viral treatment was 12. Patients can choose any medical institution for consultation based on their preference. The local health centers could trace the consultation status of all 125 HCV patients, with 119 of them receiving direct-acting antiviral (DAA) treatment. Out of the 125 patients with positive HCV antigen, 75 were evaluated at the outreach clinic, with 70 ultimately receiving DAA treatment at the outreach clinic and 5 receiving treatment at other hospitals. Evaluable sustained virological response rate for the 70 patients was 97%.
Conclusion: Prevalence-based screening and accessible outreach clinic can help accelerate HCV elimination in rural villages.
期刊介绍：
BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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