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Related Concept Videos

Hepatitis01:25

Hepatitis

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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
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Pulmonary Tuberculosis IV01:26

Pulmonary Tuberculosis IV

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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
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Point-of-Care Hepatitis C Testing in a Tribal Setting.

Jorge Mera1, Andrea Blair1, Kendra Lewis1

  • 1Department of Infectious Diseases, Cherokee Nation Health Services, Cherokee Nation Outpatient Health Center, Tahlequah, Oklahoma.

JAMA Network Open
|April 15, 2026
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Summary

Point-of-care hepatitis C virus (HCV) RNA testing in a tribal setting showed high acceptance and same-day treatment initiation for American Indian and Alaska Native individuals. This approach is feasible and effective for HCV elimination efforts.

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Area of Science:

  • Public Health
  • Infectious Disease
  • Health Equity

Background:

  • American Indian and Alaska Native populations experience disproportionately high rates of hepatitis C virus (HCV) infection and mortality.
  • Recent approval of point-of-care HCV RNA diagnostics presents an opportunity to improve testing access in underserved communities.

Purpose of the Study:

  • To evaluate the implementation of community-based, point-of-care HCV RNA testing within the Cherokee Nation.
  • To assess same-day HCV treatment uptake and identify lessons learned in a tribal health context.

Main Methods:

  • A quality improvement study was conducted at the Cherokee Nation reservation, incorporating quantitative data from surveys and electronic medical records, and qualitative data from staff meetings.
  • The study included adult participants (≥22 years) from October 2024 to May 2025, focusing on test acceptance, validity, results, and treatment initiation.

Main Results:

  • Of 405 tests offered, 348 (86%) were accepted. Valid test results showed a 10% HCV detection rate (26/274), with 46% of positive cases among American Indian and Alaska Native participants.
  • Nine participants with detectable HCV initiated treatment, and 67% of those started treatment on the same day; all were American Indian and Alaska Native individuals.
  • Initial challenges with test validity due to insufficient sample volume were overcome by implementing improved collection techniques.

Conclusions:

  • Point-of-care HCV RNA testing is feasible and effective in tribal settings, demonstrating high acceptance and facilitating same-day treatment initiation, particularly for American Indian and Alaska Native individuals.
  • Addressing logistical barriers and staff training are crucial for equitable access and successful implementation.
  • Expanding integrated point-of-care HCV testing and treatment is recommended to advance HCV elimination goals.