Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis.
Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n) = 14; pooled relative risk (RR) 1.7, 95% CI 1.3, 2.2] and patients commencing therapy (n = 4; RR 3.3, 95% CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (n = 12; RR 3.5, 95% CI 2.5, 4.8; and n = 10; RR 2.2, 95% CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (n = 4; RR 1.5, 95% CI 0.7, 3.0; and n = 4; RR 1.3, 95% CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour.
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, G4 0BA, UK, Esther.Aspinall@nhs.net.
Esther Jane
EJ
Aspinall
Joseph Samuel
JS
Doyle
Stephen
S
Corson
Margaret Elena
ME
Hellard
David
D
Hunt
David
D
Goldberg
Tim
T
Nguyen
Yngve
Y
Falck-Ytter
Rebecca Lynn
RL
Morgan
Bryce
B
Smith
Mark
M
Stoove
Stefan Zbyszko
SZ
Wiktor
Sharon
S
Hutchinson
D016174:Hepacivirus; D006526:Hepatitis C / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D035862:Vulnerable Populations