Hepatitis C Diagnosis: Simplified Solutions, Predictive Barriers, and Future Promises

Area of Science:

• Hepatology and Viral Hepatitis Diagnostics
• Public Health and Epidemiology
• Medical Technology and Innovation

Background:

• Hepatitis C diagnosis has advanced significantly with new platforms, aiding identification in high-risk groups and LMICs.
• Current diagnostic strategies are being simplified to meet the World Health Organization's 90% diagnosis goal by 2030.
• Millions of undiagnosed hepatitis C cases have been identified through improved diagnostic implementations.

Purpose of the Study:

• To review current and emerging hepatitis C diagnostic tools and strategies.
• To assess the impact of these diagnostics on reducing the global burden of hepatitis C.
• To identify challenges and propose solutions for effective hepatitis C care cascade modulation.

Main Methods:

• Overview of state-of-the-art HCV diagnostic platforms.
• Analysis of point-of-care rapid diagnostic tests (POC-RDTs), RNA reflex testing, self-test assays, and dried blood spot (DBS) analysis.
• Review of real-world clinical experiences in various settings, including mass screening and remote populations.

Main Results:

• POC-RDTs, RNA reflex testing, self-tests, and DBS analysis have demonstrated effectiveness in diverse settings.
• These advancements have facilitated the diagnosis of millions of previously undiagnosed individuals.
• The review highlights the successful implementation of new diagnostic platforms in developed and developing countries.

Conclusions:

• Simplifying diagnostic algorithms and adopting digital devices are crucial for achieving WHO hepatitis C diagnosis targets.
• Addressing challenges in affordability, accessibility, and health system barriers is essential for a 'test and treat' strategy.
• Policy and strategic interventions are needed to link diagnosis effectively to care for rapid treatment and cure.