A same day "test and treat" model for chronic HCV and HBV infection: Results from two community-based pilot studies in Egypt

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A same day "test and treat" model for chronic HCV and HBV infection: Results from two community-based pilot studies in Egypt

Authors

Shiha, G.,Soliman, R.,Serwah, A.,Mikhail, N. N.,Asselah, T.,Easterbrook, P.

Citation
2020
Journal of Viral Hepatitis

30

Type
Cross-sectional
Virus targets
Hepatitis B
Hepatitis C
Interventions
HBV testing and linkage to care
HCV testing and linkage to Care
Linkage to care
Screening and diagnosis
Testing
Setting
National
Target populations
General Population
Country of development
Egypt
Target location
Egypt
DOI
10.1111/jvh.13268
Testing strategy
Point-of-care antibody test (rapid test), Point-of-care PCR/RNA test
Point-of-care antibody test (rapid test)
Point-of-care PCR/RNA test
Countries of included studies
Egypt

Health outcomes

Receipt of antibody results,Number new diagnoses,Linkage to care,Cost

Testing strategy

Point-of-care antibody test (rapid test),Point-of-care PCR/RNA test

Abstract

Prompt access to confirmatory viral load testing and staging of liver disease are key barriers in uptake of treatment for chronic hepatitis B and C infection. Our objective was to establish the feasibility of a same day "test and treat" model in two distinct community-based settings in Egypt through use of key point-of-care portable tools for HCV and HBV viral load assessment and staging of liver disease followed by treatment initiation. Community sites were a village in northern Egypt (site 1) and a government office in Cairo (site 2). The following model was adopted: Community awareness-raising in the week before testing; site assessment to ensure optimal placement and calibration of equipment and clinical care; transfer of key portable laboratory instruments to the sites (4 cartridge GeneXpert, Fibroscan and abdominal ultrasound); screening using rapid diagnostic tests for HCV-Ab and HBsAg, with immediate venous or finger-stick blood sampling for HCV-RNA and HBV-DNA measurement, Fibroscan staging of liver disease and ultrasound screening for liver cancer. At site 1, 475 individuals were screened over a single day, 125 were positive for HCV-Ab and 4 for HBsAg, 43 of 56 new HCV diagnoses were HCV-RNA positive, and 3 of 4 HBsAg were HBV DNA positive, 40 initiated on HCV treatment, and one for HBV. At site 2, 3188 individuals were screened over 3 days, 157 were positive for HCV-Ab, and 27 for HBsAg; 38 of 76 new HCV diagnoses were HCV-RNA positive, and 15 of 18 new HBsAg diagnoses HBV DNA positive. Across both sites, 78 patients were counselled and initiated on treatment for HCV and 12 for HBV within 3 hours and 4 hours respectively of initial positive rapid diagnostic tests result. We have shown the feasibility of a same day "test and treat" model for chronic HCV and HBV infection in two community-based settings in Egypt that achieved high levels of linkage to care and initial treatment. Copyright © 2020 John Wiley & Sons Ltd.

Page updated

24 Jan 2021