HCV detection is possible during SARS CoV-2 testing; and throughout COVID-19 vaccination?

To the Editor:

Despite notable advances in the diagnosis and treatment of hepatitis C, it remains a substantial health problem. In the absence of an effective vaccine, the key elements for HCV elimination are the reduction of risk behaviors, a wide availability of HCV screening tests and unrestricted access to treatment. Unfortunately, the COVID-19 pandemic has made access to diagnosis and linkage to care extremely difficult, comprising a potential barrier that could prevent us from achieving HCV elimination, as recently demonstrated. However, all crises bring opportunities, and linking HCV screening to SARS-CoV-2 management throughout the screening or vaccination processes may be one of them.

In this regard, we read in detail the pilot project run by Giacomelli et al. in the North of Italy, wherein they took advantage of the painful COVID-19 situation. Giacomelli et al.’s study was designed to follow an opt-in protocol. This design may be affected by low/moderate engagement, as was observed in their project, with an engagement rate of below 50%. Nevertheless, they reported that half of those who tested positive were unaware of their viral status. On the other hand, considering that social and health characteristics may vary across different geographical areas, the opt-out screening approach is also a useful alternative that has been proven to be successful and cost-effective. Thus, strategies such as healthcare-associated electronic alerts or even automatic referrals for positive cases are very likely to provide an adequate linkage to care.

However, the usefulness of this new model in terms of improving healthcare access must be prospectively evaluated. In this regard, some items that must be clearly evaluated are both the acceptance and compliance of the pre-established follow-up schedule, as well as the degree of satisfaction. None of these relevant issues were reported in the work by Giacomelli et al.

Financial support

The authors received no financial support to produce this manuscript.

Authors’ contributions

All authors contributed equally.

Conflict of interests

The authors declare no conflicts of interest that pertain to this work.

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