Community‐based screening of hepatitis C with a one‐step RNA detection algorithm from dried‐blood spots: Analysis of key populations in Barcelona,Spain |
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| Authors: | V. Saludes C. Folch A. Morales‐Carmona L. Ferrer L. Fernàndez‐López R. Muñoz M. Jiménez E. Loureiro P. Fernández‐Dávila E. Bascuñana J. Casabona E. Martró |
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| Affiliation: | 1. Microbiology Service, Germans Trias i Pujol University Hospital, Germans Trias i Pujol Health Sciences Research Institute (IGTP), Badalona, Spain;2. Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain;3. Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Spain;4. Research Department, Stop Sida, Barcelona, Spain |
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| Abstract: | Alternative strategies are required to enhance the diagnosis of silent hepatitis C virus (HCV) infections in key populations at risk. Among them, HCV prevalence and bio‐behavioural data are scarce for HIV‐negative men who have sex with men (MSM) and men and trans‐women sex workers. We sought to describe and assess the potential benefits of a community‐based one‐step HCV screening and confirmatory strategy for these populations in Barcelona. The screening strategy based on a real‐time RT‐PCR assay for HCV‐RNA detection in dried‐blood spots (DBS) was validated and implemented in addition to an antibody point‐of‐care test in a community centre. HCV prevalence was assessed, and bio‐behavioural data were collected. The molecular assay was precise, reproducible, sensitive and specific. Four HIV‐negative MSM reported being currently infected (0.75% HCV self‐reported prevalence). Implementation of DBS testing was easy, and acceptability was >95%, but no silent HCV case was diagnosed (N = 580). High‐risk sexual practices and drug use for sex were reported frequently. HIV prevalence was 4.7% in MSM and 10% in sex workers. Self‐reported prevalence of other STIs ranged from 11.3% to 36.2%. In conclusion, HCV‐RNA testing in DBS showed a good performance, but the assessed one‐step strategy does not seem beneficial in this setting. Although no silent HCV infections were detected, the observed high‐risk behaviours and prevalence of other STIs suggest that HCV spread should be periodically monitored among these populations in Barcelona by means of behavioural surveillance, rapid antibody testing and molecular confirmation in DBS. |
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| Keywords: | dried‐blood spots HCV‐RNA detection men sex workers men who have sex with men sexually transmitted infection trans‐women sex workers |
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