Clinical Edge

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HCV Testing of PWID in High-Prevalence Settings

J Viral Hepat; ePub 2018 Jul 26; Scott, et al

Among people who inject drugs (PWID), WHO hepatitis C virus (HVC) elimination targets are unlikely to be met without 3-monthly RNA/cAg testing accompanied by other prevention measures, a recent study suggests. Researchers determined the testing frequencies (2-yearly, annually, 6-monthly and 3-monthly) and retention in care required among PWID to achieve the HCV incidence reduction target through treatment as prevention in low (25%), medium (50%), and high (75%) chronic HCV prevalence settings. They found:

  • In low-prevalence settings, 2-yearly antibody testing of PWID was estimated to reach the elimination target by 2027-2030 depending on retention in care, with annual testing reducing the time by up to 3 years.
  • In medium-prevalence settings, if close to 90% testing coverage were achieved, then annual antibody testing with at least 70% retention in care or annual HCV RNA/cAg testing would be required.
  • In high-prevalence settings, even 3-monthly HCV RNA/cAg testing of PWID was unable to achieve the incidence reduction target and may need other prevention measures to meet the goal.


Scott N, Sacks-Davis R, Pedrana A, Doyle J, Thompson A, Hellard M. Eliminating hepatitis C: The importance of frequent testing of people who inject drugs in high-prevalence settings. [Published online ahead of print July 26, 2018]. J Viral Hepat. doi:10.1111/jvh.12975.