Management of in- and out-of-hospital screening for hepatitis C

Area of Science:

• Hepatology
• Public Health
• Infectious Disease Epidemiology

Background:

• Chronic hepatitis C (CHC) often progresses insidiously, leading to late diagnosis and severe complications like cirrhosis and hepatocellular carcinoma.
• Direct-acting antiviral agents (DAAs) offer a cure for CHC, aligning with the World Health Organization's global viral hepatitis elimination program, though a vaccine is still in development.
• Reducing the infection source through widespread screening, diagnosis, and treatment is vital for CHC elimination, complementing efforts to block transmission routes.

Purpose of the Study:

• To analyze and recommend comprehensive management strategies for hepatitis C screening.
• To address both in-hospital and out-of-hospital screening approaches for chronic hepatitis C.
• To contribute to the development of effective hepatitis C screening strategies in China and globally.

Main Methods:

• Review of existing national and international literature on cost-effective hospital-based CHC screening strategies.
• Analysis of China's 'In-hospital process for viral hepatitis C screening and management in China (Draft)' issued in April 2021.
• Identification and consideration of special populations requiring targeted out-of-hospital screening, including blood donors, pregnant women, and high-risk groups.

Main Results:

• Hospital-based screening is recognized as a cost-effective approach for CHC management.
• China's draft guidelines provide a framework for in-hospital screening and treatment, necessitating further development of institution-specific protocols.
• Targeted screening strategies are needed for specific out-of-hospital populations to maximize early detection and intervention.

Conclusions:

• Effective CHC elimination requires a dual approach of in-hospital and targeted out-of-hospital screening.
• Developing tailored screening protocols based on institutional context and population needs is essential.
• Optimizing screening strategies is critical for reducing the burden of chronic hepatitis C and achieving global elimination goals.