Community‐based screening of hepatitis C with a one‐step RNA RNA detection algorithm from dried‐blood spots: Analysis of key populations in Barcelona, Spain

摘要

Summary 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 STI s 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 STI s 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 .