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Only 21% of people with hepatitis C have been diagnosed, WHO estimates, and innovations that can expand the availability of testing and improve uptake are urgently needed to reach the WHO target of 80% of eligible people with hepatitis C treated by 2030.
Although no direct evidence of the effectiveness of hepatitis C self-testing has been published, WHO said that studies of HIV self-testing shows that self-testing can improve the uptake of testing, results in a higher rate of diagnosis than facility-based testing and achieves similar levels of linkage to care when compared to facility-based testing.
Studies of the feasibility of hepatitis C self-testing show that most people carry out the self-test successfully and find self-testing acceptable. Self-testing has the potential to reach people who might otherwise not be tested. WHO says that although the cost per test is higher, more cases can be diagnosed through self-testing.
To implement hepatitis C self-testing, national health systems will need to look at laws and regulations on who can carry out tests, as well as ensure that quality-assured test kits are approved and procured for national programmes.
Community engagement in the development and implementation of HCV self-testing campaigns will be critical for acceptance of self-testing, as well as for generating demand. Peers will also play a key role in the distribution of self-test kits and a wide range of distribution methods must be evaluated. Information for test users and referral pathways also need to be developed.
“HIV self-testing has been an effective tool in accelerating progress towards achieving global goals, and many country programmes have benefited from the availability of HIV self-testing to support continuity of essential services in the COVID-19 context,” said Dr Meg Doherty, Director of the WHO Global HIV, Hepatitis and STI Programmes. “We encourage countries and national programmes to start planning for introduction of HCV self-testing as well, especially for priority populations and regions with the greatest gaps in testing coverage.”
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