Qualitative hepatitis C virus RNA assay identifies active infection with sufficient viral load for treatment among Phetchabun residents in Thailand

The World Health Organization envisions the elimination of viral hepatitis by 2030 through reducing prevalence and transmission, increasing diagnostic screening, and expanding treatment coverage. Efforts to micro-eliminate hepatitis in Phetchabun province in Thailand, a region where the prevalence o...

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Bibliographic Details
Published in:PloS one 2023-01, Vol.18 (1), p.e0268728-e0268728
Main Authors: Pratedrat, Pornpitra, Nilyanimit, Pornjarim, Wasitthankasem, Rujipat, Posuwan, Nawarat, Auphimai, Chompoonut, Hansoongnern, Payuda, Pimsing, Napaporn, Ngamnimit, Saranya, Thongmai, Chaiwat, Phaengkha, Wijittra, Wanlapakorn, Nasamon, Vongpunsawad, Sompong, Poovorawan, Yong
Format: Article
Language:English
Subjects:
Adult
Aged
Antibodies
Automation
Biology and life sciences
Chronic infection
Control
Coronaviruses
COVID-19
Diagnostic systems
Evaluation
Feasibility studies
Hepacivirus - genetics
Hepatitis
Hepatitis A
Hepatitis C
Hepatitis C - diagnosis
Hepatitis C - epidemiology
Hepatitis C Antibodies
Hepatitis C virus
Hepatoma
Hospitals
Humans
Identification and classification
Infection
Infections
Interferon
Liver
Liver cancer
Liver cirrhosis
Load tests
Measurement
Medical research
Medicine and health sciences
Medicine, Experimental
Middle Aged
Pandemics
People and Places
Prevention
Qualitative analysis
Ribonucleic acid
Risk factors
RNA
RNA viruses
RNA, Viral - genetics
Screening
Security
Serology
Thailand - epidemiology
Viral Load - methods
Viremia
Viruses
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Summary:The World Health Organization envisions the elimination of viral hepatitis by 2030 through reducing prevalence and transmission, increasing diagnostic screening, and expanding treatment coverage. Efforts to micro-eliminate hepatitis in Phetchabun province in Thailand, a region where the prevalence of hepatitis C virus (HCV) infection and liver cancer is higher than elsewhere in the country, began with evaluating the province-wide burden of HCV. Here, we describe a feasibility study to assess active HCV infection by screening Phetchabun residents ages 35 to 69 years for anti-HCV antibodies by using a rapid diagnostic test (RDT) at the point of care. Positive anti-HCV results were further evaluated for active infection using qualitative HCV RNA assay, followed by quantitative HCV viral load determination in a subset of samples. Currently, we have identified 6.2% (10,621/170,163) anti-HCV positive individuals, of whom 74.9% (3,930/5,246) demonstrated detectable viral RNA. Quantitative test found that 97.5% (1,001/1,027) had HCV viral load ≥5,000 IU/mL. Thus, primary screening with anti-HCV RDT followed by qualitative HCV RNA evaluation could identify active and chronic HCV infection in almost all individuals with a viral load ≥5,000 IU/mL, which is the current threshold for treatment dictated by Thailand's National Health Security Office. Our data suggest that qualitative HCV RNA evaluation may obviate the need for the more expensive quantitative HCV viral load test and reduce a significant barrier toward HCV elimination in a middle-income country.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0268728