Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis

Esther Jane Aspinall, Joseph Samuel Doyle, Stephen Corson, Margaret Elena Hellard, David Hunt, David Goldberg, Tim Nguyen, Yngve Falck-Ytter, Rebecca Lynn Morgan, Bryce Smith, Mark Stoove, Stefan Zbyszko Wiktor, Sharon Hutchinson

Research output: Contribution to journalArticle

26 Citations (Scopus)
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Abstract

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.

Original languageEnglish
Pages (from-to)115-129
Number of pages15
JournalEuropean Journal of Epidemiology
Volume30
Issue number2
Early online date11 Nov 2014
DOIs
Publication statusPublished - Feb 2015

Keywords

  • hepatitis C
  • meta-analysis
  • systematic review
  • testing

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    Aspinall, E. J., Doyle, J. S., Corson, S., Hellard, M. E., Hunt, D., Goldberg, D., ... Hutchinson, S. (2015). Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis. European Journal of Epidemiology, 30(2), 115-129. https://doi.org/10.1007/s10654-014-9958-4