title: Current challenges and possible solutions to improve access to care and treatment for hepatitis C infection in Vietnam: a systematic review.
abstract: Hepatitis C infection is a major public health concern in low- and middle-income countries where an estimated 71.1 million individuals are living with chronic infection. The World Health Organization (WHO) has recently released new guidance for hepatitis C virus (HCV) treatment programs, which include improving the access to new direct-acting antiviral agents. In Vietnam, a highly populated middle-income country, the seroprevalence of HCV infection is approximately 4% and multiple genotypes co-circulate in the general population. Here we review what is currently known regarding the epidemiology of HCV in Vietnam and outline options for reducing the significant burden of morbidity and mortality in our setting.
  
  
  
  We performed a systematic review of the currently available literature to evaluate what has been achieved to date with efforts to control HCV infection in Vietnam.
  
  
  
  This search retrieved few publications specific to Vietnam indicating a significant gap in baseline epidemiological and public health data. Key knowledge gaps identified included an understanding of the prevalence in specific high-risk groups, characterization of circulating HCV genotypes in the population and likely response to treatment, and the extent to which HCV treatment is available, accessed and utilized.
  
  
  
  We conclude that there is an urgent need to perform up to date assessments of HCV disease burden in Vietnam, especially in high-risk groups, in whom incidence is high and cross infection with multiple genotypes is likely to be frequent. Coordinating renewed surveillance measures with forthcoming HCV treatment studies should initiate the traction required to achieve the WHO goal of eliminating HCV as a public health threat by 2030, at least in this region.
authors.affiliation: Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam. aberto@oucru.org.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. aberto@oucru.org.
authors.forename: Alessandra
authors.identifier: 0000-0003-4005-9464
authors.initials: A
authors.lastname: Berto
authors.affiliation: Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Day
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Van Vinh Chau
authors.affiliation: Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
authors.forename: Guy E
authors.initials: GE
authors.lastname: Thwaites
authors.affiliation: Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.
authors.forename: Ngoc Nghiem
authors.initials: NN
authors.lastname: My
authors.affiliation: Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.|Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.|The London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Baker
authors.affiliation: Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.|Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Darton
mesh_terms: D006297:Health Services Accessibility; D016174:Hepacivirus; D006526:Hepatitis C / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D015995:Prevalence; D014744:Vietnam / Q000453:epidemiology
keywords: Epidemiology; Hepatitis C virus; Low and middle-income countries; Treatment access; Vietnam