Kyra H. Grantz, Derek A. T. Cummings, Luis Mier-y-Teran Romero, Jacqueline Astemborski, Gregory D. Kirk, David L. Thomas, Javier A. Cepeda, Shruti H. Mehta, Amy Wesolowski
{"title":"Impact of Risk Heterogeneity on the Feasibility of Hepatitis C Elimination Among People Who Inject Drugs: A Modelling Study","authors":"Kyra H. Grantz, Derek A. T. Cummings, Luis Mier-y-Teran Romero, Jacqueline Astemborski, Gregory D. Kirk, David L. Thomas, Javier A. Cepeda, Shruti H. Mehta, Amy Wesolowski","doi":"10.1111/jvh.70096","DOIUrl":"10.1111/jvh.70096","url":null,"abstract":"<p>Although previous modelling work indicates treatment of < 10 people who inject drugs (PWID) per 100 person-years (PY) could achieve hepatitis C virus (HCV) elimination targets in many settings, these models frequently make simplifying assumptions of heterogeneity in infection risk. Here, we evaluated the impact of incorporating risk heterogeneity in transmission models on the predicted effects of interventions and the feasibility of HCV elimination in high-burden settings. We built an individual-based model of HCV transmission informed by detailed data from a cohort of PWID in Baltimore, MD, including an individual- and time-varying risk multiplier on the force of infection. We contrasted these risk-informed models to risk-agnostic models, ignoring this heterogeneity, and explored various levels of treatment and harm reduction scale-up from 2020 to 2030. Risk-agnostic models routinely estimated greater reductions in incidence (8%–19% higher for treatment rates of 10–90 per 100 PY) and greater numbers of infections averted per treatment course compared to otherwise equivalent populations modelled with risk heterogeneity. Elimination targets were only achieved in risk-informed models when treating 90 PWID per 100 PY. Expanding harm reduction services dramatically improved the impact of elimination programs, particularly in averting new infections soon after treatment scale-up initiation. Achieving HCV elimination targets among PWID in high-burden settings will require substantial improvements in treatment access and harm reduction services. Models that ignore the unequal distribution of HCV risk, including the correlation between reinfection risk and onward transmission, can result in inappropriately optimistic estimates of the feasibility of elimination.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Oltmanns, Moana Witte, Anika Wranke, Katja Deterding, Heiner Wedemeyer, Christine S. Falk, Anke R. M. Kraft, Steffen B. Wiegand, Markus Cornberg
{"title":"HBV Dominance Is Associated With a Distinct Inflammatory Milieu in HBV/HCV Coinfection","authors":"Carlos Oltmanns, Moana Witte, Anika Wranke, Katja Deterding, Heiner Wedemeyer, Christine S. Falk, Anke R. M. Kraft, Steffen B. Wiegand, Markus Cornberg","doi":"10.1111/jvh.70092","DOIUrl":"10.1111/jvh.70092","url":null,"abstract":"<p>Hepatitis B (HBV) and C (HCV) virus coinfection is linked to a higher risk of cirrhosis and hepatocellular carcinoma (HCC) compared to monoinfection. Despite this, data are limited, and further investigation is needed to understand the underlying mechanisms. While patients are classified based on dominance patterns, the impact on the immune system remains largely unknown. It is recognised that HBV reactivation may occur following HCV clearance. This study aims to explore the potential immune interactivity between HCV and HBV by analysing patterns of soluble immune mediators (SIM). A total of 58 soluble immune mediators were measured in serum or plasma samples of 49 patients chronically infected with hepatitis B and hepatitis C virus in a cross-sectional study design. Patients were classified based on dominance patterns: HBV dominance (<i>n</i> = 8), HCV dominance (<i>n</i> = 22), HBV and HCV codominance (<i>n</i> = 11) and no dominance (<i>n</i> = 8). SIM expression was distinct based on different dominance patterns. HBV activity induced higher SIM expression and altered the soluble inflammatory milieu (22 SIM altered, <i>p</i> < 0.05). Altered pathways included JAK–STAT pathway (<i>p</i> = 1.36 × 10<sup>−20</sup>), IL-17 signalling (<i>p</i> = 2.47 × 10<sup>−13</sup>) and Th17 cell differentiation (<i>p</i> = 1.69 × 10<sup>−9</sup>). CCL27/CTACK (<i>r</i> = −0.69, <i>p</i> = 7.02 × 10<sup>−6</sup>) and SDF-1alpha (<i>r</i> = −0.55, <i>p</i> = 0.002) correlated inversely with HCV-RNA. Serologically classifying dominance patterns in HBV and HCV coinfection may manifest in a distinct soluble inflammatory milieu. Elevated HBV activity correlates with an increased expression of soluble immune mediators, particularly influencing the alteration of key signalling pathways such as JAK–STAT and the Th17/IL-17 axis. These changes have a potential role in the development of liver fibrosis.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12522073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana R. Hardie, Stephen N. J. Korsman, Ziyaad Valley-Omar, Nadia Petersen, Russell Cable, C. Wendy Spearman, Mark Sonderup
{"title":"Performance Evaluation of the Elecsys HCV Duo Immunoassay in the Public Healthcare Setting in Cape Town, South Africa","authors":"Diana R. Hardie, Stephen N. J. Korsman, Ziyaad Valley-Omar, Nadia Petersen, Russell Cable, C. Wendy Spearman, Mark Sonderup","doi":"10.1111/jvh.70095","DOIUrl":"10.1111/jvh.70095","url":null,"abstract":"<p>Improved HCV diagnosis and linkage to care is crucial to achieve WHO 2030 elimination targets. Simplification of diagnostics remains key. We evaluated the performance of Elecsys HCV Duo antigen/antibody immunoassay in patients using public healthcare in Cape Town, South Africa. 253 HCV seropositive and 214 seronegative samples were tested, and results correlated with standard-of-care (SOC) serology, HCV RNA, viral genotype, patient demographics, and disease markers. Thirteen patients on antiviral therapy were also evaluated. Elecsys HCV Duo antibody was equivalent to SOC serology, while antigen had 100% negative percent agreement in non-viraemic samples. One incident infection with viral load (VL) of 54,000 IU/mL was antigen positive/antibody negative. Overall, antigen detection was 63.2% in RNA-positive samples. VL strongly predicted reactivity, with antigen positive rates of 17.5% (< 5 log IU/mL), 75.8% (5–6 log IU/mL), 89.4% (6–7 log IU/mL), and 100% (> 7 log IU/mL). Detection in genotype-1 infections was significantly better, at 69.6% (95% CI 59.5–79.7) than non-genotype-1 at 43.2% (95% CI 28.7–57.7). In treated patients, antigen mirrored RNA clearance but was only reliable if positive at baseline. Elecsys HCV Duo detected active infection in 63% of viraemic patients, 70% with genotype 1. In our cohort, 49% of new patients would require VL testing.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tiancheng Xie, Mengyang Su, Min Cai, Tianshuo Zhao, Xiyu Zhang, Sihui Zhang, Mingting Wang, Qingsong Xu, Yujie Cheng, Shuang Gao, Fuqiang Cui
{"title":"Real-World Study for Mother-To-Child Transmission of Hepatitis B in Guangdong Province, 2021–2023","authors":"Tiancheng Xie, Mengyang Su, Min Cai, Tianshuo Zhao, Xiyu Zhang, Sihui Zhang, Mingting Wang, Qingsong Xu, Yujie Cheng, Shuang Gao, Fuqiang Cui","doi":"10.1111/jvh.70094","DOIUrl":"10.1111/jvh.70094","url":null,"abstract":"<p>This study aimed to evaluate the status of hepatitis B virus (HBV) mother-to-child transmission (MTCT) among infants born to hepatitis B surface antigen (HBsAg)-positive mothers from 2021 to 2023 and identify key factors influencing HBV MTCT, providing critical insights to inform future HBV prevention strategies. Data were obtained from the case records of HBsAg-positive pregnant women and their newborns in Guangdong Province from January 1, 2021, to December 31, 2023. For HBsAg and anti-HBs positive rates, bivariate analysis was conducted to examine associations between maternal and infant characteristics. Additionally, Firth's bias reduction logistic regression analysis was conducted to identify factors influencing MTCT. Our study analysed data from 131,781 HBsAg-positive pregnant women and their newborns in Guangdong Province from 2021 to 2023. Among 131,781 infants completing PVST, the overall HBV MTCT rate was 0.44%, with an anti-HBs positivity rate of 93.48%. Maternal age, administration of HepB-BD and HBIG and use of antiviral treatment during pregnancy were significantly associated with HBV MTCT. However, birth weight, maternal education level, mode of delivery and number of births were not significantly associated with HBV MTCT risk. This study provides a comprehensive analysis of HBV MTCT among HBsAg-positive pregnant women and their infants in Guangdong Province from 2021 to 2023. Despite significant advancements in HBV MTCT prevention, our findings underscore the need for enhanced strategies, particularly for pregnant women with high HBV viral loads. Strengthening maternal antiviral treatment, ensuring timely and comprehensive infant follow-up, and implementing targeted health education programs will be essential for further reducing MTCT rates and improving long-term outcomes.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorenzo Badia, Alessia Ciancio, Marco Distefano, Antonio Izzi, Alessandro Loglio
{"title":"Applying the COM-B Model to Identify Barriers to Bulevirtide Adherence in Chronic Hepatitis D: A Multicenter Italian Study","authors":"Lorenzo Badia, Alessia Ciancio, Marco Distefano, Antonio Izzi, Alessandro Loglio","doi":"10.1111/jvh.70097","DOIUrl":"https://doi.org/10.1111/jvh.70097","url":null,"abstract":"<p>Adherence to treatment is a key determinant of clinical outcomes in chronic infectious diseases, including hepatitis D virus (HDV) infection. Even if bulevirtide (BLV) has shown a promising adherence profile in clinical trials, adherence is often compromised by various barriers in the context of HDV—especially among migrant populations. The aim of this study was to investigate the factors influencing adherence to BLV treatment in real-life settings in Italy. From May to September 2024, two anonymous surveys—one for HDV patients undergoing bulevirtide (BLV) treatment and one for their hepatologists—were conducted across five tertiary centers in Italy. The study employed the COM-B model (Capability, Opportunity, Motivation–Behaviour) to systematically explore the behavioural drivers influencing treatment adherence in this population and unmet needs. Of the 86 consecutive adult patients receiving bulevirtide (BLV) who were invited to participate, 83 (97%) completed the multilingual survey (35% > 60 years old, 48% Italians; 80% under BLV > 6 months) and were included in the analysis, together with 13 hepatologists. The findings revealed key challenges related to patient education, logistical access to medication, and psychological factors affecting motivation. Specifically, 10% had considered discontinuing treatment and 10% admitted to having missed doses. A deeper understanding of these multifactorial determinants may aid in the development of targeted interventions to enhance adherence and achieve personalized therapeutic outcomes for individuals living with HDV.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reassessing Cost-Effective Strategies for Hepatitis B Elimination: The Urgent Need for Action-Oriented Screening Models","authors":"Gokhan Koker","doi":"10.1111/jvh.70084","DOIUrl":"10.1111/jvh.70084","url":null,"abstract":"","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher J. Gonzalez, Clarence N. Perez-Mejia, Noelia Hernandez, Shashi N. Kapadia, Jeff Niederdeppe, Arpan Dharia, Zoi Papalamprakopoulou, Andrew H. Talal, Audrey R. Lloyd, Ricardo Franco, Martin F. Shapiro, Elaine Wethington
{"title":"Identifying Varying Influences on Eliminating Hepatitis C Across Medical Specialties","authors":"Christopher J. Gonzalez, Clarence N. Perez-Mejia, Noelia Hernandez, Shashi N. Kapadia, Jeff Niederdeppe, Arpan Dharia, Zoi Papalamprakopoulou, Andrew H. Talal, Audrey R. Lloyd, Ricardo Franco, Martin F. Shapiro, Elaine Wethington","doi":"10.1111/jvh.70093","DOIUrl":"https://doi.org/10.1111/jvh.70093","url":null,"abstract":"<div>\u0000 \u0000 <p>Objective:To identify specialty-specific influences in administering HCV treatment among primary care, gastroenterology/hepatology, infectious diseases, and addiction specialties, and strategies to potentially eliminate HCV. Study Setting and Design:Qualitative study using remote interviews with healthcare providers in New York and Alabama who treated or screened patients for HCV, purposefully sampling for specialty, clinical setting, and HCV treatment experience. Data sources and Analytic Sample: Interviews occurred 9/2021–8/2022. Transcripts were analyzed using a hybrid inductive-deductive approach; a content analysis identified codes arising uniquely within specialties. Results: Thirty-six providers were interviewed: primary care (<i>n</i> = 9), addiction medicine (<i>n</i> = 12), infectious diseases (<i>n</i> = 9), and gastroenterology/hepatology (<i>n</i> = 6). Distinct challenges and facilitators emerged across specialties. Primary care and addiction providers similarly emphasized the convenience and usual practice of referring patients to specialists for HCV treatment, while infectious disease and gastroenterology noted challenges with patients not completing the referrals. Primary care providers expressed wanting training and peer support related to treatment provision. Addiction providers described structural barriers, such as lacking on-site phlebotomy services and patients' competing health concern prioritization, but highlighted strategies to improve treatment access, including trust-building. Infectious disease providers highlighted using patient navigators to overcome logistical barriers, while gastroenterologists emphasized collaborative relationships, particularly with addiction specialists. Specialty-specific opportunities emerged regarding training, collaboration, navigation, and infrastructure. Conclusions:Eliminating HCV requires addressing specialty-specific concerns for providers managing HCV. Potential opportunities include dissemination of specialty-tailored training, facilitating interdisciplinary care and desired cross-specialty collaborations, and overcoming unique infrastructural needs. Future research should evaluate implementation strategies addressing these specialty-specific needs.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Didier Laureillard, Nguyen Thanh Binh, Vu Hai Vinh, Tran Thi Hong, Catherine Quillet, Nham Thi Tuyet Thanh, Roselyne Vallo, Bach Thi Nhu Quynh, Jean Pierre Moles, Khuat Thi Hai Oanh, Duong Thi Huong, Delphine Rapoud, Jonathan Feelemyer, Laurent Michel, Peter Vickerman, Hannah Fraser, Laurence Weiss, Maud Lemoine, Karine Lacombe, Don Des Jarlais, Pham Minh Khue, Nicolas Nagot
{"title":"High Efficiency and Safety of Hepatitis C Treatment Among People Who Inject Drugs in Vietnam","authors":"Didier Laureillard, Nguyen Thanh Binh, Vu Hai Vinh, Tran Thi Hong, Catherine Quillet, Nham Thi Tuyet Thanh, Roselyne Vallo, Bach Thi Nhu Quynh, Jean Pierre Moles, Khuat Thi Hai Oanh, Duong Thi Huong, Delphine Rapoud, Jonathan Feelemyer, Laurent Michel, Peter Vickerman, Hannah Fraser, Laurence Weiss, Maud Lemoine, Karine Lacombe, Don Des Jarlais, Pham Minh Khue, Nicolas Nagot","doi":"10.1111/jvh.70090","DOIUrl":"10.1111/jvh.70090","url":null,"abstract":"<p>People who inject drugs (PWID) are highly affected by hepatitis C (HCV) worldwide, particularly in low- and middle-income countries (LMICs), where access to addiction services is often limited. Reducing the burden of HCV, as promoted by WHO, requires effective interventions in this high-risk population. Here, we report the safety and efficacy of a pangenotypic generic HCV treatment among PWID in Vietnam, using a sofosbuvir/daclatasvir regimen. PWID were screened for HCV at two community-based organisations (CBO) premises in Haiphong during both a respondent-driven sampling survey and cohort follow-up visits. PWID with detectable HCV RNA were referred to three public hospitals for a 12-week regimen of generic sofosbuvir/daclatasvir, with ribavirin if cirrhosis, and with CBO support for referral and adherence. Treatment safety was assessed over the course of treatment and success was measured by sustained virologic response 12 weeks after the end of treatment (SVR12). Of the 1201 PWID screened with detectable HCV RNA, 1021 were enrolled: 96% male, median age 42 years, 45% HIV-infected, 16% with advanced liver fibrosis, 55% currently injecting, and 71.5% on methadone maintenance therapy (MMT). In total, 979 participants started HCV treatment, and 901 of the 924 participants tested at SVR12 (98%) were cured. Genotype 3, current drug use, lack of MMT, and HIV infection were independently associated with treatment failure. High HCV cure rates can be achieved among PWID in LMICs such as Vietnam using a simple model of care, including a pangenotypic generic direct-acting antiviral combination and CBO support.</p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03537196</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marc G. Ghany, John W. Ward, Zachary Baldwin, Shiyin Jiao, Nidhi Shukla, Arina Kuznetsova, Jatinder Kaur, Katherine J. Kosch, Timothy R. Morgan
{"title":"HCV Testing and Treatment of Adults in the United States: 2014 Through 2021—Data From Two National Commercial Testing Laboratories","authors":"Marc G. Ghany, John W. Ward, Zachary Baldwin, Shiyin Jiao, Nidhi Shukla, Arina Kuznetsova, Jatinder Kaur, Katherine J. Kosch, Timothy R. Morgan","doi":"10.1111/jvh.70087","DOIUrl":"10.1111/jvh.70087","url":null,"abstract":"<p>Data on the hepatitis C virus (HCV) care cascade are crucial for determining if the United States (U.S.) is on track to meet 2016 World Health Organization elimination goals. De-identified data were analysed from persons who were screened for HCV antibody and/or tested for HCV RNA by two large U.S. commercial laboratories from 1/1/2014 to 12/31/2021. Validated imputation algorithms were used to identify persons who initiated treatment and who achieved virological cure based on viral load decline and continued negative HCV RNA test results. The 3-digit ZIP code was used to map treatment rates by U.S. state. During 1/1/2014 to 12/31/2021, a total of 46,646,661 persons were tested for HCV antibody of whom 2,253,500 (4.8%) were positive. Among 3,117,372 persons tested for HCV RNA, 1,951,742 (62.6%) were viremic. Cumulatively, a total of 672,745/1,951,742 (34.5%) viremic persons were treated; an estimated 643,043 (96%) were cured. Treatment rates increased with older age, higher fibrosis scores, HIV positivity, residing in an urban area and in the Northeast. Persons diagnosed by reflex testing had higher treatment rates. Comparing COVID-19 pandemic (2021) to pre-pandemic (2019) periods, 24% more HCV antibody tests were performed (10,167,524 vs. 7,727,318), but fewer persons were treated (21,136 vs. 26,124, 23% decline) and cured (19,584 vs. 24,480, 25.0% decline) in 2021, respectively. In 2021, primary care providers diagnosed and treated the greatest proportion of persons. Treatment uptake across the U.S. remains low, underscoring the need for additional measures to expand access to testing and treatment, necessary to reach the U.S. goals for HCV elimination by 2030.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Huma Qureshi, Jesse A. Canchola, Ghayas Hai, Amtul Quddos Latif, Neil T. Parkin, Benjamin La Brot
{"title":"Evaluation of Blood Droplet Volumes on the Cobas Plasma Separation Card for HCV RNA Testing in Resource-Limited Settings","authors":"Huma Qureshi, Jesse A. Canchola, Ghayas Hai, Amtul Quddos Latif, Neil T. Parkin, Benjamin La Brot","doi":"10.1111/jvh.70091","DOIUrl":"https://doi.org/10.1111/jvh.70091","url":null,"abstract":"<p>Detection of viral RNA is essential for hepatitis C virus (HCV) diagnosis. Collection and preservation of plasma, the preferred specimen type, is challenging in some areas. The Cobas Plasma Separation Card (PSC) is an alternative specimen type with no cold chain requirements. The PSC is designed to use capillary blood from fingerstick and capillary tube collection, but alternative sample collection options would broaden PSC utility. This study explored qualitative and quantitative HCV RNA detection with PSC prepared using a syringe needle, compared to plasma. Using a 24-gauge syringe, blood was drawn by venipuncture from HCV antibody-positive clinic patients aged > 18 years and used to prepare plasma or spotted directly onto three PSCs using 6, 8 and 10 drops per spot (group 1) or 8, 10 and 12 drops (group 2). HCV RNA was measured using the Cobas HCV assay. Test results for all conditions were available for 143 patients in group 1 and 109 patients in group 2. The proportions with detectable HCV RNA were not significantly different from plasma, and overall agreement was over 88% for any PSC spot number (Fisher exact test <i>p</i> > 0.1). The mean HCV viral load was lower for PSC samples vs. plasma for six or eight spots in group 1 but not statistically different for 10 or 12 spots in either group. Direct spotting of blood using a syringe is a viable alternative to finger prick and capillary tube transfer for PSC preparation. This approach may be beneficial in resource-limited settings and in patient populations for whom capillary blood collection is challenging.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"32 11","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.70091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}