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    Hidden chronic hepatitis C infections remain hard to detect

    A public health and primary care birth cohort testing strategy does not detect hidden hepatitis C virus (HCV) infections, according to a new study.

    Strategies to detect HCV and hepatitis B virus (HBV) hidden in the general population have been disappointing. “Past drug users or recipients of blood transfusions remain hidden as they may not remember or report these behaviors. Additionally, not all HCV cases are part of a known risk group. To capture all persons who have HCV infection, prospective studies were needed to evaluate the diagnostic yield of HCV testing strategies not based on exposure risk factors,” Jeanne Heil, MSc, of the Public Health Service in Heerlen, The Netherlands, told Medical Economics.

    The researchers published their results January 8, 2018 in Annals of Family Medicine.

    A prospective cohort study set out to determine the test uptake and positivity rate of a combined public health and primary care birth cohort testing strategy in detecting hidden cases of HCV and HBV. The study included 6,743 adults registered with 11 family practices serving two higher prevalence areas in the Netherlands.

    “This best-practice testing strategy was effective in achieving a high test uptake of 51%, and detected HBV cases mainly in non-western migrants. However, it completely failed to detect hidden chronic HCV infections and is not recommended for lower prevalence countries. Most surprising was that no active HCV infections were found,” said Heil.

    The researchers expected a higher prevalence based on previous estimations in the hotspots, the overall prevalence of the general population, and based on the estimated hidden population.

    Mark L. Fuerst
    Staff Correspondent


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