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

Abstract

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抯 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. ? 2023 Pratedrat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use distribution and reproduction in any medium provided the original author and source are credited.