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Updated: Jul 3, 2026
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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Optimizing Hepatitis C Virus Antibody Testing Strategy and Setting: Results From a Large Real-World Screening
Grishma Hirode1, Camelia Capraru1, Aaron Vanderhoff1
1Toronto Centre for Liver Disease/Viral Hepatitis Care Network (VIRCAN), University Health Network, Toronto, Ontario, Canada.
Open Forum Infectious Diseases
|July 2, 2026
Summary
Optimal hepatitis C virus (HCV) screening is crucial for elimination. This study shows that while some patients are lost during the care cascade, treatment initiation is high, especially when matching HCV antibody testing to the right setting.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Optimal hepatitis C virus (HCV) screening is essential for preventing transmission and achieving global elimination targets.
- Administrative data offers insights into testing and treatment trends, but understanding care cascade barriers requires more detailed information.
- A real-world analysis was conducted to document the HCV care cascade and evaluate the effectiveness of different HCV antibody (Ab) screening methods across various settings.
Purpose of the Study:
- To document the hepatitis C virus (HCV) care cascade in a real-world setting.
- To evaluate the effectiveness of different HCV antibody (Ab) screening modalities across diverse community and clinical environments.
- To identify barriers and facilitators in the HCV care cascade for individuals undergoing testing.
Main Methods:
- A cross-sectional study was performed involving individuals who underwent HCV Ab testing.
- Data was collected from participating centers in Ontario, Canada, between May 2010 and June 2023.
- The study analyzed the care cascade from HCV Ab positivity through RNA testing, follow-up, treatment initiation, completion, and sustained virologic response.
Main Results:
- HCV Ab prevalence was 13.6% among 61,605 tested individuals, peaking in the 35-44 age group (23.2%) and at addiction clinics (41.0%).
- Among HCV Ab-positive individuals, 79.7% had RNA testing, with 57.3% testing positive.
- Linkage to care was most effective when HCV Ab testing was conducted in primary care settings, with high rates of treatment initiation (61.1% of RNA-positive) and completion (47.3% of RNA-positive).
Conclusions:
- Despite some attrition in the HCV care cascade, treatment initiation rates were higher than administrative data suggested.
- Utilizing multiple HCV testing modalities is beneficial.
- Matching the optimal HCV antibody testing modality to the specific clinical or community setting enhances linkage to care pathways.
