Journal of Global Infectious Diseases

EDITORIAL
Year
: 2017  |  Volume : 9  |  Issue : 2  |  Page : 39--40

State of the globe: Hepatitis C – Opportunistic versus organized screening


Sunil Kumar Raina1, Vivek Chauhan2, Suman Thakur3,  
1 Department of Community Medicine, Dr. RPGMC, Kangra, Himachal Pradesh, India
2 Department of Medicine, Dr. RPGMC, Kangra, Himachal Pradesh, India
3 Department of Microbiology, Dr. RPGMC, Kangra, Himachal Pradesh, India

Correspondence Address:
Vivek Chauhan
Department of Medicine, Dr. RPGMC, Kangra - 176 001, Himachal Pradesh
India




How to cite this article:
Raina SK, Chauhan V, Thakur S. State of the globe: Hepatitis C – Opportunistic versus organized screening.J Global Infect Dis 2017;9:39-40


How to cite this URL:
Raina SK, Chauhan V, Thakur S. State of the globe: Hepatitis C – Opportunistic versus organized screening. J Global Infect Dis [serial online] 2017 [cited 2021 Mar 5 ];9:39-40
Available from: https://www.jgid.org/text.asp?2017/9/2/39/206946


Full Text

Saini et al. have reported a rise in hepatitic C virus (HCV) infection rate among the blood donors in Central India.[1]

HCV-related deaths per year are on the rise. The 2015 Global Burden of Disease study showed that the estimated number of deaths due to hepatitis C in 1990 and 2013 was 333,000 and 704,000, respectively.[2],[3] This indicates that there is a continuous increase in incident cases of hepatitis C, which may be largely attributable to the increased use of parenteral preparation and injection drug use.[4] Although with the universal screening of blood for HCV, a decline in incidence has been observed, still a large number of cases of hepatitis C continue to suffer from HCV-related cirrhosis and hepatocellular carcinoma.[5]

The global resurgence in HCV cases has been noticed, especially in injection drug users and HIV-infected men who have sex with men.[6],[7] A systematic review in 2013 estimates that about 184 million persons have a history of HCV infection (anti-HCV antibody) and about 130–150 million out of these may have chronicity (HCV RNA positive).[8] Although the recent reviews may point toward a lower prevalence, the number of people needing treatment for complications of HCV remains quite high.[9] A 5-year data analysis on the seroprevalence of transfusion-transmitted infections among blood donors in an Indian setting revealed that though the prevalence had decreased over a 5-year period but was still significant.[10]

 Recommendations on Screening



Two strategies for screening have been in use: first one uses organized screening programs (through mass or high-risk screening programs) to identify people with HCV infection and the second approach is that of opportunistic screening. Opportunistic screening is easy and sustainable; the organized screening needs the establishment of services at various health-care delivery setups with uniform standards and may not be financially viable. As it is obvious from the estimates derived till now, a large number of people will have to be invited to take part in these organized screening programs to be successful.

The opportunistic screening for HCV can be conducted as and when someone asks for it or it can be offered at the time of blood testing for some other purposes. Unlike an organized screening program, opportunistic screening need not be monitored, and the cost will be minimal. Since we all seek or receive a health test or checkup in our lifetimes, the yield from such opportunistic screening programs will be substantial.

As an early guideline for conducting opportunistic screening, the World Health Organization list on populations with a high HCV prevalence or a history of HCV risk exposure/behavior will be useful.[11]

Any individual who received medical or dental interventions in health-care settings with below standard infection control practicesAny individual who has received blood transfusions before serological testing of blood donors for HCV was initiatedAny individual who has received blood transfusions in a country where serological testing of blood donations for HCV is not routinely performedPeople who inject drugsAny individual who have had tattoos, body piercing, or scarification procedures in a setting where infection control practices are below standardChildren born to mothers infected with HCVHIV-infected individualsIndividuals use/using/have used intranasal drugsPrisoners and previously incarcerated persons.

References

1Saini PA, Chakrabarti PR, Varma AV, Gambhir S, Tignath G, Gupta P. Hepatitis C virus: Unnoticed and on the rise in blood donor screening? A 5 years cross-sectional study on seroprevalence in voluntary blood donors from central India. J Global Infect Dis 2017;9:51-5.
2Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2095-128.
3GBD Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385:117-71.
4Magiorkinis G, Magiorkinis E, Paraskevis D, Ho SY, Shapiro B, Pybus OG, et al. The global spread of hepatitis C virus 1a and 1b: A phylodynamic and phylogeographic analysis. PLoS Med 2009;6:e1000198.
5Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm. J Viral Hepat 2014;21 Suppl 1:34-59.
6Conrad C, Bradley HM, Broz D, Buddha S, Chapman EL, Galang RR, et al. Community outbreak of HIV infection linked to injection drug use of oxymorphone – Indiana, 2015. MMWR Morb Mortal Wkly Rep 2015;64:443-4.
7Wandeler G, Schlauri M, Jaquier ME, Rohrbach J, Metzner KJ, Fehr J, et al. Incident hepatitis C virus infections in the Swiss HIV cohort study: Changes in treatment uptake and outcomes between 1991 and 2013. Open Forum Infect Dis 2015;2:ofv026.
8Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: New estimates of age-specific antibody to HCV seroprevalence. Hepatology 2013;57:1333-42.
9Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol 2014;61 1 Suppl:S45-57.
10Raina S, Raina SK, Kaul R, Sharma V. Seroprevalence of hepatitis B, hepatitis C, human immunodeficiency virus surface, and syphilis among blood donors: A 6-year report from a sentinel site in Western Himalayas, India. Indian J Sex Transm Dis 2015;36:220-1.
11WHO: Guidelines for the Screening, Care and Treatment of Persons with Chronic Hepatitis C Infection. Updated Version; April, 2016. Available from: http://www.who.int/hiv/pub/hepatitis/hepatitis-c-guidelines/en. [Last accessed on 2017 May 16].