Closing the gaps in the hepatitis C care cascade

As the world seeks to achieve the WHO 2030 elimination goals, screening, diagnosis, and linkage to care have been identified as key challenges given that over 50% of people living with HCV remain unaware of their status. One challenge that is sometimes overlooked is the importance of linkage to care. Without strong linkage to care, elimination programs will never be able to meet their goals. Many patients fall off the care cascade in two stages: 1) connecting from antibody to confirmatory testing and 2) confirmatory testing to treatment. Interventions- both technological and behavioral- are needed to strengthen these linkages and to re-engage patients once they have fallen out of care. In light of World Hepatitis Day and a renewed global commitment to hepatitis elimination, this webinar will map the key elimination challenges related to loss to follow-up and put forth possible solutions to reducing these gaps.


1. Introduction to the challenges

  • Gaps in Current HCV Diagnostic Algorithm and the Future of Viral Hepatitis Testing: Innovations in Testing Technologies and Approaches, Philippa Easterbrook, WHO

2. Strengthening linkages from antibody to confirmatory testing

  • Significant Improvement in Diagnosis of Hepatitis C Virus Infection by a One-Step Strategy in a Central Laboratory, Francisco Rodríguez, Frías University Hospital Vall d'Hebron, Barcelona
  • Multicentre Evaluation of Dried Blood Spot (DBS) and Plasma Separation Card (PSC) samples for the quantitative detection of HCV RNA, Elena Ivanova Reipold, FIND

3. Strengthening linkages from diagnosis to treatment & Re-engaging patients in care once they are lost to follow-up

  • iThemba Life: Empowering HCV patients to engage in care and treatment, Samanta Lalla-Edward, University of the Witwatersrand, South Africa
  • Re-engaging Patients in HCV care: Real-World Experience from the US Department of Veterans Affairs, Angela Park and Rachel Gonzalez
  • A Digital Case-Finding Algorithm for Diagnosed but Untreated Hep C: A Tool for Increasing Linkage to Treatment and Cure, Brooke Wyatt, Icahn School of Medicine Mount Sinai

Additional resources

Peeling RW, Boeras DI, Marinucci F, Easterbrook P. The future of viral hepatitis testing: innovations in testing technologies and approaches. BMC Infect Dis. 2017;17(Suppl 1):699. Published 2017 Nov 1. doi:10.1186/s12879-017-2775-0

Wyatt, B., Perumalswami, P. V., Mageras, A., Miller, M., Harty, A., Ma, N., Bowman, C. A., Collado, F., Jeon, J., Paulino, L., Dinani, A., Dieterich, D., Li, L., Vandromme, M., & Branch, A. D. (2021). A Digital Case-Finding Algorithm for Diagnosed but Untreated Hep C: A Tool for Increasing Linkage to Treatment and Cure. Hepatology (Baltimore, Md.), 10.1002/hep.32086. Advance online publication.