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Background <p>The WHO aims to eliminate hepatitis B virus (HBV) and hepatitis C virus (HCV) as public health threats by 2030, yet diagnosis remains suboptimal in many low- and middle-income countries. Access to diagnostics is often emphasized, but how far existing capacity is used is poorly characterized. We quantified installed capacity and utilization of HBV/HCV testing across three primary-care–linked Vietnamese facilities and described disease stage.</p> Methods <p>We conducted a cross-sectional inventory and utilization audit of serologic (HBsAg, anti-HCV) and molecular (HBV DNA, HCV RNA) testing during 2018–2020 at a private diagnostic network, a public district hospital, and a teaching/research institute. Utilization was tests performed divided by maximum theoretical capacity. Facility-level data on fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) at diagnosis were drawn from routine records.</p> Results <p>In 2019 (pre-COVID-19 reference year), serologic and PCR utilization were 50.0% and 18.8% at the private network, 5.0% and 21.3% at the public hospital, and lowest at the teaching institute (3.5% and 3.0%). Advanced fibrosis (≥ F3) rose over 2018–2020 from 11.4% to 16.6% in HBV and 21.6% to 37.5% in HCV. Most HCC occurred in individuals with HBV infection (52.3% and 21.4% at the two larger sites) and coexisted with high unused capacity; we did not assess testing accuracy.</p> Conclusions <p>Substantial HBV/HCV diagnostic infrastructure exists in Vietnam but is unevenly used. Because data were facility-aggregated, these are associations, not patient-level causal relationships. Optimizing use of existing platforms may help address systemic inefficiencies and support elimination efforts.</p>

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Diagnostic capacity and utilization of Hepatitis B and C testing across multiple health care sectors in Vietnam

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月26日

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  • Quan Le,
  • Ngoc Thai Truong,
  • Diem Dao,
  • Amy Trang,
  • Van Nguyen,
  • Hang Dao,
  • Bao Q. Duong,
  • Hai Phan,
  • Mary Smith,
  • Chase Yonamine,
  • Tanya Machado,
  • Doan Y. Dao

摘要

Background

The WHO aims to eliminate hepatitis B virus (HBV) and hepatitis C virus (HCV) as public health threats by 2030, yet diagnosis remains suboptimal in many low- and middle-income countries. Access to diagnostics is often emphasized, but how far existing capacity is used is poorly characterized. We quantified installed capacity and utilization of HBV/HCV testing across three primary-care–linked Vietnamese facilities and described disease stage.

Methods

We conducted a cross-sectional inventory and utilization audit of serologic (HBsAg, anti-HCV) and molecular (HBV DNA, HCV RNA) testing during 2018–2020 at a private diagnostic network, a public district hospital, and a teaching/research institute. Utilization was tests performed divided by maximum theoretical capacity. Facility-level data on fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) at diagnosis were drawn from routine records.

Results

In 2019 (pre-COVID-19 reference year), serologic and PCR utilization were 50.0% and 18.8% at the private network, 5.0% and 21.3% at the public hospital, and lowest at the teaching institute (3.5% and 3.0%). Advanced fibrosis (≥ F3) rose over 2018–2020 from 11.4% to 16.6% in HBV and 21.6% to 37.5% in HCV. Most HCC occurred in individuals with HBV infection (52.3% and 21.4% at the two larger sites) and coexisted with high unused capacity; we did not assess testing accuracy.

Conclusions

Substantial HBV/HCV diagnostic infrastructure exists in Vietnam but is unevenly used. Because data were facility-aggregated, these are associations, not patient-level causal relationships. Optimizing use of existing platforms may help address systemic inefficiencies and support elimination efforts.