Diagnosis and screening currently too complex and expensive, but new options emerging.

UNITAID’s review of testing technologies for hepatitis C (HCV) published today, finds that although current diagnosis and screening options for the disease remain too complex and expensive for widespread scale up, there are some emerging technologies which could change this situation.  The new report, Hepatitis C Diagnostics Technology Landscape [PDF, 4 MB], follows an initial scoping report released in 2013 that explored the many issues and challenges related to HCV treatment and diagnosis. The new landscape report identifies several simpler tests which will enable diagnosis and monitoring closer to the point-of-care with the patient.  Some of these are expected to reach the market later this year.

There are 130 to 150 million people infected globally with HCV, the vast majority of whom are unaware of their status because the initial stages of infection have no symptoms. It is the potential long-term effects that are the most damaging: cirrhosis, liver cancer and liver failure.  Screening and monitoring is vital to enable treatment, but can cost $300-1,400 per patient, out of reach for most middle-income countries which have 75% of those infected. Few individuals therefore currently access HCV testing and treatment, including only a small fraction of the estimated 4 to 5 million people who are co-infected with HIV and HCV.

In the longer term, identification of infected patients is also important to help build the market intelligence that will be necessary to encourage new drug manufacturers to enter the market and enable treatment options to be made more affordable and accessible, especially for the newly developed highly effective medicines which can cure the disease.  UNITAID has already started investing to make some of these new medicines more affordable for those in need.

The report also describes some of the challenges associated with implementing HCV testing in low-resource settings, where factors like cost, infrastructure requirements and the need for trained laboratory technicians limit tests’ availability. Where they are available at all today, technologies are often deployed only at the national reference laboratory level. These conclusions are echoed by the outcomes reached at UNITAID’s HIV Market Forum, a gathering of global HIV experts last year.

• Download: HCV Diagnostic Landscape – 1st edition. UNITAID. January 2015