Department of Internal Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana.
Department of Internal Medicine, Cape Coast Teaching Hospital, Cape Coast, Ghana.
PLoS One. 2023 Jun 23;18(6):e0287580. doi: 10.1371/journal.pone.0287580. eCollection 2023.
The current burden of Hepatitis C virus infection and the availability of HCV-related services in Ghana are not well described. Previous estimates on HCV seroprevalence in the country are outdated. This study investigated the HCV seroprevalence and testing and treatment capacity in Ghana. A multi-centre cross-sectional study was conducted in which laboratory and blood bank registers from 17 public healthcare institutions in Ghana were reviewed. A survey on cost and availability of HCV-related testing and treatment was also performed. Crude and pooled estimates of HCV seroprevalence, frequency and median cost of available diagnostic tests and medicines were described. The crude HCV seroprevalence was 2.62% (95% CI 2.53-2.72) and the pooled estimate was 4.58% (95% CI 4.06-5.11) among 103,609 persons tested in laboratories. Age (OR 1.02 95% CI 1.01-1.02) and male sex (OR 1.26 95% CI 1.08-1.48) were predictors of a positive anti-HCV RDT test. Northern administrative regions in Ghana had the highest HCV seroprevalence ranging from 8.3-14.4%. Among 55, 458 potential blood donors, crude HCV seroprevalence was 3.57% (95% CI 3.42-3.72). Testing was through Rapid Diagnostic Test (RDT) kits in most facilities, and only 2 of 17 centres were performing HCV RNA testing. The median cost of an anti-HCV RDT test was $0.97 (0-1.61) and $3.23 (1.61-7.58) for persons with and without government health insurance respectively. The median cost of a 12-week course of the pan-genotypic direct-acting antiviral therapy sofosbuvir-daclatasvir was $887.70. In conclusion, there are significant regional differences in HCV burden across Ghana. Limited access to and cost of HCV RNA and DAA therapy hinders testing and treatment capability, and consequently HCV elimination efforts. A national HCV program supported with a sustainable financing plan is required to accelerate HCV elimination in Ghana.
目前加纳的丙型肝炎病毒（HCV）感染负担和 HCV 相关服务的提供情况尚未得到充分描述。之前对该国 HCV 血清流行率的估计已经过时。本研究旨在调查加纳的 HCV 血清流行率以及检测和治疗能力。进行了一项多中心横断面研究，对加纳 17 家公立医疗机构的实验室和血库登记进行了审查。还进行了一项关于 HCV 相关检测和治疗的成本和可及性的调查。描述了 HCV 血清流行率的粗率和汇总估计值、可用诊断检测和药物的频率和中位数成本。在实验室接受检测的 103609 人中，HCV 血清流行率的粗率为 2.62%（95%CI 2.53-2.72），汇总估计值为 4.58%（95%CI 4.06-5.11）。年龄（OR 1.02，95%CI 1.01-1.02）和男性（OR 1.26，95%CI 1.08-1.48）是抗 HCV 快速诊断检测呈阳性的预测因素。加纳北部行政区域的 HCV 血清流行率最高，范围为 8.3-14.4%。在 55458 名潜在献血者中，HCV 血清流行率的粗率为 3.57%（95%CI 3.42-3.72）。大多数机构都通过快速诊断检测（RDT）试剂盒进行检测，只有 17 个中心中的 2 个能够进行 HCV RNA 检测。抗 HCV RDT 检测的中位数费用为 0.97 美元（0-1.61 美元）和 3.23 美元（1.61-7.58 美元），分别为有和没有政府医疗保险的人。泛基因型直接作用抗病毒治疗索磷布韦-达拉他韦 12 周疗程的中位数费用为 887.70 美元。总之，加纳各地的 HCV 负担存在显著的区域差异。HCV RNA 和 DAA 治疗的可及性和费用有限，阻碍了检测和治疗能力，从而影响了 HCV 的消除工作。加纳需要一个有可持续供资计划支持的国家 HCV 计划，以加快 HCV 的消除。
