Hepatitis C Screening in Malaysia – #MYmissingmillions
Generate evidence to inform policy change and scale up access to hepatitis C diagnosis and treatment
last phase of drug development
updated 1 Mar 2022
In July 2018, DNDi and diagnostic product development and delivery partnership FIND announced a partnership, in collaboration with the Ministry of Health in Malaysia, to generate evidence to support policy change and scale up HCV diagnosis and treatment.
As a part of the project, simplified decentralized screening for HCV was initiated in Malaysia. People who screen positive and are subsequently confirmed to have HCV were linked to treatment either in government hospitals or, on a voluntary basis, as part of the DNDi clinical trial.
This study was conducted between December 2018 and October 2019 at 25 primary healthcare clinics (PHCs) in three regions in Malaysia. Each PHC was linked to one or more hospital, for referral of seropositive participants for confirmatory testing and pre-treatment evaluation. Treatment was provided at PHCs for non-cirrhotic patients and at hospitals for cirrhotic patients.
This 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, which has led to national scale-up of HCV management in primary care clinics across Malaysia.
Project updates
2021
The results of the study were published in December 2021, demonstrating the effectiveness and feasibility of a simplified, decentralised HCV testing and treatment model in primary healthcare settings, targeting high-risk groups in Malaysia.
The study showed a total of 15,366 adults screened at 25 PHCs, using rapid diagnostic tests for HCV antibodies. Among 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 pre-treatment 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.
2019
Ahead of World Hepatitis Day 2019, the Malaysian Ministry of Health, DNDi, and FIND launched the #MYmissingmillions campaign to raise awareness of the importance of early HCV diagnosis and treatment. The partnership offered Malaysians, especially those considered to be at high risk, the opportunity to be screened at more than 100 hospitals, primary healthcare centres, and study sites located across the country’s 14 states, and to receive highly effective treatment free of charge.
More than 11,000 patients were screened over the course of 2019, with over 400 people linked to HCV treatment in government hospitals and 23 as part of the DNDi clinical trial.
News & resources
- 12 April 2022 – A quasi-randomised controlled trial of online distribution of home-based hepatitis C self-testing for key populations in Malaysia: a study protocol, Trials
- 24 December 2021 – 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, BMJ Open
- 17 July 2019 – Nationwide hepatitis C screening campaign initiated by the Malaysian Ministry of Health
- 23 July 2018 – FIND and DNDi team up to support Malaysian MOH efforts to simplify and decentralize hepatitis C screening & treatment
More information
- Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders. BMC Public Health, February 2022
- Treatment coverage and drug expenditure in hepatitis C patients from 2013 to 2019: A journey of improving treatment accessibility in Malaysia through government-led initiatives
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