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What Is Needed to Move Toward Single-Step Diagnosis of Current HCV Infection?
1Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Insights
Hepatitis C virus (HCV) elimination is stalled by complex diagnosis. Simplifying HCV testing to a single step is crucial for improving care linkage and achieving global HCV elimination goals.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Hepatitis C virus (HCV) infection remains a significant global health issue despite effective treatments.
- Direct-acting antivirals achieve high cure rates, but HCV elimination progress is hindered by diagnostic and care linkage challenges.
Purpose of the Study:
- To review current challenges in HCV diagnosis and linkage to care.
- To explore new technologies and strategies for simplifying HCV diagnosis.
- To identify pathways for improving HCV elimination efforts.
Main Methods:
- Review of current HCV diagnostic paradigms.
- Analysis of challenges in the cascade of care for HCV.
- Exploration of novel diagnostic technologies and existing tool-based strategies.
Main Results:
- The current two-step HCV diagnostic process (antibody then RNA test) is a major barrier.
- Simplified, single-step diagnostic methods are needed to improve diagnosis and linkage to care.
- Technological advancements and strategic use of existing tools can facilitate simpler diagnosis.
Conclusions:
- Achieving global HCV elimination requires overcoming diagnostic complexities.
- Implementing single-step HCV diagnostic tests is essential for improving patient access to care and treatment.
- Innovations in diagnostics are key to accelerating progress towards HCV eradication.
Abstract:
Despite remarkable therapeutic advances, hepatitis C virus (HCV) infection continues to be a major global problem. While the development of highly effective direct-acting antivirals has ensured that almost all those who are treated achieve viral cure, progress toward HCV elimination globally has stalled due to challenges upstream of treatment in the cascade of care, namely diagnosis and linkage to care. The major challenge continues to be the relative complexity of HCV diagnosis with the current requirement for a confirmatory HCV RNA test after an initial antibody-positive result. In this review, challenges with the current paradigm are highlighted with a focus on new technologies, as well as simple strategies using existing tools, which may simplify diagnosis and improve linkage to care and treatment. To achieve HCV elimination, improvements in the HCV diagnostics field to allow for a simple single-step diagnosis are required.
