Hepatitis C virus (HCV) — a potentially fatal infection that attacks the liver — is a critical health problem for people living with HIV. Indeed, it's estimated that 2.3 million people around the world have an HIV/HCV coinfection.

Tackling coinfection is key to HCV elimination, says Dr Francesco Marinucci, Head of HCV & HIV at FIND, a global non-profit organisation accelerating the development, evaluation and delivery of diagnostic tests for poverty-related diseases. A response is needed urgently. Numbers of HCV cases are rising, and four out of five people are unaware that they have the disease.


HCV symptoms may not be present until it is too late


“HCV symptoms may only become evident when the patient is in the advanced stages of liver disease, which might be too late, or too complicated, to treat,” says Dr Marinucci. “That's why it's so important to have strategies in place for early detection of HCV.”

Antiviral medicines are now available that cure more than 95% of people with hepatitis C. So, in terms of cost effectiveness and relieving the burden on over-stretched health systems, it makes more sense to offer people a $1 HCV screening test, than to wait for them to develop the harder-to-treat, advanced-stage disease.


Screen for HCV while screening for HIV


What's needed is a patient-centred, integrated approach that uses new diagnostic tools and infrastructure within existing services. “If people are being tested at an HIV clinic, they should also be screened for hepatitis C and hepatitis B,” reasons Dr Marinucci. “It's a waste of resources to run just one HIV test in a laboratory that could run multiple tests for other diseases.”

Lessons learned from the global response to HIV are now needed in the fight against HCV. “Take task-shifting,” says Dr Marinucci. “This allowed nurses and other health-workers to provide basic services for people with HIV that, in the past, had been in the hands of a few clinicians. That proved to be very effective for HIV— and it can easily be applied to HCV.” The development of new, quality diagnostic tools — another barrier to access — must be expanded, he says.


Learn more about HEAD-Start


With support from Unitaid, FIND is working to improve diagnosis of hepatitis C by making it more affordable and more widely available to those in need, with a focus on serving people coinfected with HIV. The Hepatitis C Elimination through Access to Diagnostics (HEAD-Start) project is designed to drive a change in global implementation guidelines and national policies that are conducive to scaling up hepatitis C management in support of the WHO elimination targets for 2030. Twitter: @FINDdx