LITERATURE UPDATE
Testing, diagnosis, and treatment following the implementation of a program to provide dried blood spot testing for HIV and hepatitis C infections: the NSW DBS Pilot Carrington N, Conway A, Grebely J et al.; NSW DBS Pilot Study Group. BMC Infect Dis. 2024 Jan 29; 24(1): 137. doi: 10.1186/s12879-024-08989-8.
Dried blood spot (DBS) testing provides an alternative to phlebotomy and addresses barriers to accessing healthcare experienced by some key populations. Large-scale evaluations of DBS testing programmes are needed to understand their feasibility. This study evaluated the implementation of a state- wide DBS HIV and hepatitis C virus (HCV) testing pilot. The New South Wales (NSW) DBS Pilot is an interventional cohort study of people testing for HIV antibody and/ or HCV RNA from DBS samples in NSW, Australia. Participants at risk of HIV/ HCV participated in testing via: 1) self- registration online with a DBS collection kit delivered and returned by conventional postal service; or 2) assisted DBS sample collection at 36 community health sites (including drug treatment and harm- minimisation services) and prisons. Participants received results by text (HIV antibody/HCV RNA not detected) or a healthcare provider (HIV antibody/HCV RNA detected). The RE-AIM framework was used to evaluate reach, effectiveness, adoption, and implementation. Reach: Between November 2016
and December 2020, 7,392 individuals were tested for HIV and/or HCV (21% self-registration, 34% assisted in community, and 45% assisted in prison). Effectiveness: Of 6,922 people tested for HIV (19% men who have sex with men, 13% living outside major cities, 21% born outside Australia), 51% (3,521/6,922) had no HIV test in the past two years, 0.1% (10/6,922) were newly diagnosed with HIV, and 80% (8/10) initiated HIV treatment within six months. Of 5,960 people tested for HCV (24% women, 35% Aboriginal and/or Torres Strait Islander, 55% recently injected drugs), 15% had detectable HCV RNA (878/5,960), and 45% (393/878) initiated treatment within six months. Adoption: By the end of 2020, DBS via assisted registration was available at 36 community sites and 21 prisons. Implementation: 90% of DBS cards arriving at the laboratory had the three full spots required for testing; the proportion was higher in assisted (94%) compared to online (76%) registration. This study demonstrated the feasibility
of DBS testing for HIV and HCV in key populations including Aboriginal and
Hepatocellular carcinoma, the most common form of primary liver cancer (Trichrome stain).
Torres Strait Islander peoples, men who have sex with men, people who inject drugs, and demonstrated the utility of DBS in the prison seting.
Update on Pediatric Hepatitis C Infection Ferreira J, Sheflin-Findling S. Curr Gastroenterol Rep. 2025 Feb 28; 27 (1): 18. doi: 10.1007/s11894-024-00955-3.
Hepatitis C virus (HCV) infections continue to steadily increase in the United States and remain a major public health challenge. This review aims to provide a comprehensive overview of HCV infection in children, focusing on recent advancements in screening, diagnosis, and treatment.
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WWW.PATHOLOGYINPRACTICE.COM September 2026 Effective screening strategies, including
universal screening of pregnant women and nucleic acid testing for all perinatally exposed infants at 2 to 6 months of age, have been implemented to identify infected individuals early. Direct-acting antiviral agents have revolutionised treatment, offering high cure rates for children of all ages. Despite significant progress, challenges
remain in achieving HCV elimination. These include the need for improved access to testing and treatment, as well as ongoing efforts to develop a preventive vaccine. Continued research and implementation of effective strategies are essential to reduce the burden of HCV infection.
PPi
Nephron CC BY-SA 3.0 Wikimedia Commons
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