HCV and HBV prevalence based on home blood self-sampling and screening history in the general population in 2016: contribution to the new French screening strategy

Cécile Brouard, Leïla Saboni, Arnaud Gautier, Stéphane Chevaliez, Delphine Rahib, Jean-Baptiste Richard, Francis Barin, Christine Larsen, Cécile Sommen, Josiane Pillonel, Elisabeth Delarocque-Astagneau, Nathalie Lydié, Florence Lot, 2016 Health Barometer Group, Cécile Brouard, Leïla Saboni, Arnaud Gautier, Stéphane Chevaliez, Delphine Rahib, Jean-Baptiste Richard, Francis Barin, Christine Larsen, Cécile Sommen, Josiane Pillonel, Elisabeth Delarocque-Astagneau, Nathalie Lydié, Florence Lot, 2016 Health Barometer Group

Abstract

Background: The advent of effective direct-acting antivirals (DAAs), has prompted an assessment of the French Hepatitis C virus (HCV) screening strategy, which historically targeted high-risk groups. One of the options put forward is the implementation of combined (i.e., simultaneous) HCV, Hepatitis B virus (HBV) and HIV screening for all adults at least once during their lifetime ("universal combined screening"). However, recent national survey-based data are lacking to guide decision-making regarding which new strategy to implement. Accordingly, we aimed to provide updated data for both chronic hepatitis C (CHC) and B (CHB) prevalence and for HCV and HBV screening history, using data from the BaroTest and 2016 Health Barometer (2016-HB) studies, respectively.

Methods: 2016-HB was a national cross-sectional phone based health survey conducted in 2016 among 20,032 randomly selected individuals from the general population in mainland France. BaroTest was a virological sub-study nested in 2016-HB. Data collected for BaroTest were based on home blood self-sampling on dried blood spots (DBS).

Results: From 6945 analyzed DBS, chronic hepatitis C (CHC) and B (CHB) prevalence was estimated at 0.30% (95% Confidence Interval (CI): 0.13-0.70) and 0.30% (95% CI: 0.13-0.70), respectively. The proportion of individuals aware of their status was estimated at 80.6% (95% CI: 44.2-95.6) for CHC and 17.5% (95% CI: 4.9-46.4) for CHB. Universal combined screening would involve testing between 32.6 and 85.3% of 15-75 year olds according to whether we consider only individuals not previously tested for any of the three viruses, or also those already tested for one or two of the viruses.

Conclusions: Our data are essential to guide decision-making regarding which new HCV screening recommendation to implement in France. They also highlight that efforts are still needed to achieve the WHO's targets for eliminating these diseases. Home blood self-sampling may prove to be a useful tool for screening and epidemiological studies.

Keywords: France; Hepatitis B; Hepatitis C; Prevalence; Screening.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
*15,216 participants were recruited from the national sample and 4,816 from regional subsamples. ** 499 persons were not eligible because they were aged of 15-17 years and 99 because they did not have health insurance coverage or because they were under guardianship. One thousand six hundred fifty-three persons were eligible to BaroTest but were not invited to participate to BaroTest due to out of stock of self-sampling kits

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