The Current Paradigms of Hepatitis C Diagnosis and Innovations in the Pipeline

Considering advances in hepatitis C therapy, global management of HCV infection becomes practicable, but some influential factors, like the capacity of countries to identify and proper diagnosis of infected individuals with immense HCV genotypic variations among different global regions and at-risk populations, cannot be passed over. Approximately, 71 million people are infected with chronic HCV infection and about 80% of them remain undiagnosed. Standard protocol for HCV diagnosis includes a preliminary serological (HCV antibody) test accompanied by an expensive confirmatory test for HCV RNA detection in serum samples of patients. However, gaps remain in the accessibility, affordability, and availability of goldstandard HCV diagnostic strategies. In pursuance of achieving the goals of the World Health Organization (WHO) for HCV elimination as a public health threat by 2030, efficient, reliable, and simplified diagnostic pathways are needed to unveil. As such, simplified sensitive strategies that can enhance the single-test diagnostic approach might assist linkage to care and direct-acting antivirals (DAAs) treatment uptake. Herein, we will discuss a few advanced diagnostic approaches to subdue some of these constraints. HCV self-testing and digital devices for the detection of HCV infection would be of prime importance in the near future. Furthermore, the availability of smart, robust, and mobile diagnostic platforms to find the missing millions in harder-to-reach populations and vulnerable individuals would also be required to link every diagnosed one with cascades of care. We will briefly cover all aspects of HCV screening and diagnostic algorithms in this book chapter along with potential advantages and disadvantages.