Screening for hepatitis c in average and high-risk populations of qatar using rapid point-of-care testing

Abstract

Background: Screening for hepatitis C has been found to be beneficial in high-risk individuals and ‘baby boomers’. Objective: Our aim was to screen for hepatitis C in average and high-risk individuals and compare the disease characteristics and response to treatment among the screened group (SG) and non-screened group (NSG). Method: Community-based screening for hepatitis C was done in the average and high-risk populations of Qatar. Screening was done using rapid point-of-care testing. All patients with stage 1 fibrosis on liver biopsy were treated with pegylated interferon and ribavirin. Results: In total, 13,704 people were screened and 272 (2%, 95% CI (1.8–2.2%) had positive antibodies to hepatitis C. During the same period, 237 non-screened patients (NSG) with hepatitis C were referred for treatment. Alanine and aspartate  aminotransferases (ALT, AST) and overall fibrosis were significantly lower in the SG as compared with the NSG (p¼0.04, 0.04 and 0.01, respectively). The response to treatment was similar in the SG as compared with the NSG (sustained viral response 61.7 % versus 69.1%, p¼0.55). Average-risk patients had significantly lower ALT levels (p¼0.04) but had similar response to treatment as the high-risk individuals (sustained viral response 63.2 % versus 61%, p¼0.87). Conclusion: Screening detects hepatitis C with lesser fibrosis but does not result in better response to pegylated interferon and ribavirin as compared with non-screened patients.