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. 2019 Dec;26(12):1431-1453.
doi: 10.1111/jvh.13182. Epub 2019 Aug 16.

Hepatitis B and C testing strategies in healthcare and community settings in the EU/EEA: A systematic review

Lauren M K Mason  1 , Irene K Veldhuijzen  2 , Erika Duffell  3 , Ayla van Ahee  1 , Eveline M Bunge  1 , Andrew J Amato-Gauci  3 , Lara Tavoschi  3
Affiliations

Hepatitis B and C testing strategies in healthcare and community settings in the EU/EEA: A systematic review

Lauren M K Mason et al. J Viral Hepat. 2019 Dec.

Abstract

An estimated 9 million individuals are chronically infected with hepatitis B virus (HBV) and hepatitis C virus (HCV) across the European Union/European Economic Area (EU/EEA), many of which are yet to be diagnosed. We performed a systematic review to identify interventions effective at improving testing offer and uptake in the EU/EEA. Original research articles published between 1 January 2008 and 1 September 2017 were retrieved from PubMed and EMBASE. Search strings combined terms for HBV/HCV, intervention, testing and geographic terms (EU/EEA). Out of 8331 records retrieved, 93 studies were selected. Included studies reported on testing initiatives in primary health care (9), hospital (12), other healthcare settings (31) and community settings (41). Testing initiatives targeted population groups such as migrants, drug users, prisoners, pregnant women and the general population. Testing targeted to populations at higher risk yielded high coverage rates in many settings. Implementation of novel testing approaches, including dried blood spot (DBS) testing, was associated with increased coverage in several settings including drug services, pharmacies and STI clinics. Community-based testing services were effective in reaching populations at higher risk for infection, vulnerable and hard-to-reach populations. In conclusion, our review identified several successful testing approaches implemented in healthcare and community settings, including testing approaches targeting groups at higher risk, community-based testing services and DBS testing. Combining a diverse set of testing opportunities within national testing strategies may lead to higher impact both in terms of testing coverage and in terms of reduction, on the undiagnosed fraction.

Keywords: Europe; hepatitis B; hepatitis C; screening; testing.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
PRISMA flow diagram for the systematic review
See this image and copyright information in PMC

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