Observational studyBMJ open2021
Assessing the impact of simplified HCV care on linkage to care amongst high-risk patients at primary healthcare clinics in Malaysia: a prospective observational study.
Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Acceptability and Effectiveness of Point-of-Care HCV Testing in Low- and Middle-Income Countries: A Systematic Review.Liver international : official journal of the International Association for the Study of the Liver · 2026Pooled it
- Integrated Care Models for Hepatitis C: Lessons From Southeast Asia and Sub-Saharan Africa.Open forum infectious diseases · 2025Article
- Community-based versus facility-based services to improve hepatitis C screening in Cambodia: a cluster randomized controlled trial (ANRS 12384 Cam-C study).The Lancet regional health. Western Pacific · 2025Article
- Feasibility of a prison-based test-and-treat model for enhancing hepatitis C care in Kedah, Malaysia.BMC public health · 2025Article
- Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions.Nature reviews. Gastroenterology & hepatology · 2024Review
- Molecular Point-of-Care Testing for Hepatitis C: Available Technologies, Pipeline, and Promising Future Directions.The Journal of infectious diseases · 2024Review
- Knowledge, Attitude and Factors associated with Self-efficacy in Screening and Treatment of Hepatitis C among Primary Care Doctors in Selangor.Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2024Article
- Usability and acceptability of oral fluid- and blood-based hepatitis C virus self-testing among the general population and men who have sex with men in Malaysia.PLOS global public health · 2024Article
- Cost-effectiveness of a decentralized, community-based "one-stop-shop" hepatitis C testing and treatment program in Yangon, Myanmar.JGH open : an open access journal of gastroenterology and hepatology · 2023Article
- Public reimbursement policies in Canada for direct-acting antiviral treatment of hepatitis C virus infection: A descriptive study.Canadian liver journal · 2023Article
- Assessing feasibility of a modified same-day test-and-treat model for hepatitis C among rural people who inject drugs.Harm reduction journal · 2023Article
- Diagnostic performance of two non-invasive biomarkers used individually and in sequential combination for cirrhosis associated with hepatitis C virus infection.Scientific reports · 2022Article
Corrections and comments
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Authors and funding
27 authors at 13 institutions in 5 countries.
Funding
Abstract
introductionTo achieve the elimination of hepatitis C virus (HCV), substantial scale-up in access to testing and treatment is needed. This will require innovation and simplification of the care pathway, through decentralisation of testing and treatment to primary care settings and task-shifting to non-specialists. The objective of this study was to evaluate the feasibility and effectiveness of decentralisation of HCV testing and treatment using rapid diagnostic tests (RDTs) in primary healthcare clinics (PHCs) among high-risk populations, with referral of seropositive patients for confirmatory viral load testing and treatment.
methodsThis observational study was conducted between December 2018 and October 2019 at 25 PHCs in three regions in Malaysia. Each PHC was linked to one or more hospitals, for referral of seropositive participants for confirmatory testing and pretreatment evaluation. Treatment was provided in PHCs for non-cirrhotic patients and at hospitals for cirrhotic patients.
resultsDuring the study period, a total of 15 366 adults were screened at the 25 PHCs, using RDTs for HCV antibodies. Of the 2020 (13.2%) HCV antibody-positive participants, 1481/2020 (73.3%) had a confirmatory viral load test, 1241/1481 (83.8%) were HCV RNA-positive, 991/1241 (79.9%) completed pretreatment assessment, 632/991 (63.8%) initiated treatment, 518/632 (82.0%) completed treatment, 352/518 (68.0%) were eligible for a sustained virological response (SVR) cure assessment, 209/352 (59.4%) had an SVR cure assessment, and SVR was achieved in 202/209 (96.7%) patients. A significantly higher proportion of patients referred to PHCs initiated treatment compared with those who had treatment initiated at hospitals (71.0% vs 48.8%, p<0.001).
conclusionsThis study demonstrated the effectiveness and feasibility of a simplified decentralised HCV testing and treatment model in primary healthcare settings, targeting high-risk groups in Malaysia. There were good outcomes across most steps of the cascade of care when treatment was provided at PHCs compared with hospitals.
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