Focus Area - Hepatitis C

Hepatitis C virus (HCV) is a significant public health problem affecting 58 million people worldwide with 1.5 million new infections each year. Effects of chronic infection include liver cirrhosis, hepatocellular carcinoma, and extra-hepatic manifestations such as lichen planus, cryoglobulinemia, and lymphoma. Most people infected with HCV experience little to mild symptoms, and as a result are unaware of their infection. Rising rates of HCV infection have been a cause of concern, especially amongst young adults who inject drugs. People who inject drugs (PWID) bear a significant burden of HCV infections, with estimated prevalence ranging from 50-90%.

Oral direct-acting antiviral (DAA) tablets are highly effective at clearing HCV infections. Access to treatment has greatly improved since generic versions have been introduced in low- and middle- income countries with curative regimens costing around $50.

While access to treatment has improved, only 21% of the estimated 58 million people living with HCV infection know of their diagnosis. Diagnostic testing for HCV is currently a blood test, often based on the detection of HCV RNA. These tests are often sent to a reference laboratory. Antibody tests do not have the ability to differentiate between past or current infections.

Current tests include:

• Screening tests for antibodies to determine prior exposure
• RNA tests to detect or quantify hepatitis C virions in blood
• Genotyping tests to determine strain of HCV and the presence of drug resistance mutations