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

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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

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Hepatitis C Antibodies
Meta-Analysis
Hepacivirus
Morbidity
Liver
Virus Diseases
Therapeutics
Risk-Taking

Keywords

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

Cite this

Aspinall, Esther Jane ; Doyle, Joseph Samuel ; Corson, Stephen ; Hellard, Margaret Elena ; Hunt, David ; Goldberg, David ; Nguyen, Tim ; Falck-Ytter, Yngve ; Morgan, Rebecca Lynn ; Smith, Bryce ; Stoove, Mark ; Wiktor, Stefan Zbyszko ; Hutchinson, Sharon. / Targeted hepatitis C antibody testing interventions : a systematic review and meta-analysis. In: European Journal of Epidemiology. 2015 ; Vol. 30, No. 2. pp. 115-129.
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Aspinall, EJ, Doyle, JS, Corson, S, Hellard, ME, Hunt, D, Goldberg, D, Nguyen, T, Falck-Ytter, Y, Morgan, RL, Smith, B, Stoove, M, Wiktor, SZ & Hutchinson, S 2015, 'Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis', European Journal of Epidemiology, vol. 30, no. 2, pp. 115-129. https://doi.org/10.1007/s10654-014-9958-4

Targeted hepatitis C antibody testing interventions : a systematic review and meta-analysis. / Aspinall, Esther Jane; Doyle, Joseph Samuel; Corson, Stephen; Hellard, Margaret Elena; Hunt, David; Goldberg, David; Nguyen, Tim; Falck-Ytter, Yngve; Morgan, Rebecca Lynn; Smith, Bryce; Stoove, Mark; Wiktor, Stefan Zbyszko; Hutchinson, Sharon.

In: European Journal of Epidemiology, Vol. 30, No. 2, 02.2015, p. 115-129.

Research output: Contribution to journalArticle

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T2 - a systematic review and meta-analysis

AU - Aspinall, Esther Jane

AU - Doyle, Joseph Samuel

AU - Corson, Stephen

AU - Hellard, Margaret Elena

AU - Hunt, David

AU - Goldberg, David

AU - Nguyen, Tim

AU - Falck-Ytter, Yngve

AU - Morgan, Rebecca Lynn

AU - Smith, Bryce

AU - Stoove, Mark

AU - Wiktor, Stefan Zbyszko

AU - Hutchinson, Sharon

PY - 2015/2

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N2 - 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.

AB - 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.

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