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Table 1 Nonintegrated screening programs in intermediate to high HCV-prevalence countries (>2%)

From: Outcomes of hepatitis C screening programs targeted at risk groups hidden in the general population: a systematic review

Program characteristics

Program outcomes

First author, year of publication

Calendar year of data collection

Population

Country and HCV prevalence according to CDC[23]

Setting of screening

Duration of screening program

Other tests

Pre-screening selection

Media activities

Screening uptake and anti-HCV prevalence (95% CI)

Risk profile of identified HCV cases/Risk factors associated with HCV

Follow-up of HCV-infected individuals

Meky et al. 2006 [55]

2002-2005

General population

Egypt (6.6%): Two rural villages in the Nile Delta

Community health clinic and private clinics for acute cases

29 months

HAV, HBV, HEV, CMV, Epstein-Barr

Only those with symptoms and ALT levels = > 2 times the upper limit of normal were tested

Yes

Scr. uptake: NR

Prevalence: 78.7% (37/47; 95% CI:65.1-88.0*

NR

At 2 and 6 months following initial examination, follow-up testing was done to confirm or reclassify the diagnosis (i.e., viral clearance or persistent infection). No data was reported about medical follow-up of chronically infected patients.

Outcomes:

RNA rate: 70.2% (33/37)

Start treatment: NR

SVR: NR

Chen et al. 2007 [58]

1996-2005

General population aged ≥18 yrs

Taiwan (2.1% a): throughout the country

Outreach community based screening

10 years

HBV, ALT, AST

No

Yes

Scr. uptake: NR

Prevalence: 4.4% (6904/157720; 95% CI: 4.3-4.5)**

NR

Patients were requested to return to the collaborating hospitals for subsequent management (results were not reported).

Outcomes:

RNA rate: NR

Start treatment: NR

SVR: NR

Aslam & Aslam 2001 [57]

2000

General population

Pakistan (6.6%): Lahore and Gujranwala

City screening program

NR

None

No

Yes

Scr. uptake: Lahore: 0.01% 488/5063500

Gujranwala: 0.2% (1922/1124800)

Prevalence: Lahore: 16% (78/488; 95% CI:13.0-19.5)

Gujranwala: 23.8% (458/1922; 95% CI: 22.0-25.8)*

Listed risk factors:

- Blood transfusion

- Surgery/dental work

- Multiple factors - Mostly other, non-specified risk factors

Patients were informed about the possibility of eradication of the virus, and treatment in its early stages (further data not provided)

Outcomes:

RNA rate: NR

Start treatment: NR

SVR: NR

Lu et al. 1998 [56]

1994

General population <16 yrs

Taiwan (2.1% a): Paisha Township, Penghu Islets

Kindergartens and schools

1 month

HBV

No

NR

Scr. uptake: 93.6% (1164/1243)

Prevalence: 0.9% (11/1164; 95% CI: 0.5-1.7) overall*

3–6 yrs: 0%

7–12 yrs: 0.8%

13–15 yrs: 1.9%

Listed risk factors: - Surgery

- Intramuscular injection

- Intravascul ar injection, - Intravascular infusion

All anti-HCV positive children were followed annually for 2 years with upper abdominal sonography, AST, ALT, anti-HCV and HCV RNA. No data was reported about medical follow-up of chronically infected children.

           

Outcomes:

RNA rate: 27.3% (3/11)

Start treatment: NR

SVR: NR

  1. Note: CI = confidence interval; NR = not reported; IDU = injecting drug use; HCV = hepatitis C virus; HBV = hepatitis B virus; HAV = hepatitis A virus; HEV = hepatitis E virus; CMV = cytomegalovirus; ALT = alanine aminotransferase; AST = aspartate aminotransferase; SVR = sustained virological response.
  2. *HCV-antibody prevalence is considered suboptimal (data were collected before 1994 when sensitivity/specificity of tests was not optimal, or reactive HCV-antibody test results were not confirmed by immunoblot).
  3. **The reliability of the reported HCV-antibody prevalence is undecided (data were collected after 1993, but the diagnostic tests are unspecified, or other than described below (see ***), or dried blood spots or oral fluid samples were used).
  4. ***HCV-antibody prevalence is considered valid; data were collected after 1993, and reactive HCV-antibody test results were confirmed by second or higher generation immunoblot assays from Ortho, Chiron, Novartis (RIBA), Innogenetics (LiaTek), Pasteur (DECISCAN HCV), Genelabs Diagnostics (HCV BLOT), or Mikrogen (recomBlot HCV IgG 2.0).
  5. aHCV prevalence based on prevalence of country neighbours.