Development of a laboratory network for confirmatory testing of hepatitis C virus infection using HCV viral load quantification methods between 2022 and 2024

Abstract

This report presents the results of the development of a laboratory network for confirmatory testing of hepatitis C virus infection, aiming to improve service accessibility in line with the Public Health Laboratory concept, support confirmatory testing services for individuals with positive screening results, and to facilitate the implementation of the Department of Disease Control's policies. The implementation was conducted in three phases: a pilot phase, a service development phase, and a scale-up phase, by providing HCV viral load testing reagents for a total of 10,796 tests, with a budget of 12.5 million baht over a three-year period (2022-2024), including capacity development, technical consultation, and laboratory quality assurance. The network expanded from 10 facilities (2022) to 52 facilities (2024). Data from the National Health Security Office (NHSO) indicate that the number of service sites increased from 23 facilities (2021) to 399 facilities (2024), representing an increase of more than 17 folds. Moreover, the number of services increased from 1,182 service visits in 2021 to 26,667 service visits in 2024, representing more than a 22-fold increase. After three years of implementation, a survey of hepatitis confirmatory testing services was conducted in 2025. Out of 159 respondents, after data verification, 75 facilities across 56 provinces were found to be providing confirmation testing services, as follows: (1) 60 facilities in 48 provinces provided confirmation testing services for both hepatitis B and C; (2) 2 facilities in two provinces provided confirmation testing services for hepatitis B; and (3) 13 facilities in 11 provinces provided confirmatory testing services for hepatitis C. The main limitations include the cost burden, procurement process, referral system, and reimbursement system for service fees. Therefore, further development of the sample referral system, capacity building for personnel, sustained budget support, and continuous public awareness campaigns are recommended to achieve the goal of hepatitis elimination by 2030.