Table 1.

The unmet needs and solutions to HCV screening management in countries of different incomes.

Unmet needs	More fitting solutions
Common barriers
Poor awareness of HCV screening in physicians and unawareness of HCV infection status in patients contribute to continued HCV transmission and missed prevention.	Adopt risk-based HCV testing in low- or middle-income countries, universal testing to targeted groups or general population in high-income countries.
	Promote periodly awareness campaigns for the public, educate at-risk populations and patients, provide professional training to health care workers.
Substantial participants do not link to care after screening.	Streamline the procedure of HCV cascade cure.
	Well-trained general practitioners charge for patients' screening, diagnosis and therapy.
Unique Barriers
Low-and middle-income countries
Limited health-care resource and insurance coverage schemes induce poor access to HCV test.	Request assistance from non-government foundations.
A high proportion of individuals with HCV infection remain undiagnosed.	Adopt micro-elimination strategy in targeted populations, with gradual transition to universal screening.
The lack of laboratory equipment and technology restricts the advantages of NAT. HCV screening of blood donors is inadequate.	Choose easy-to-operate and highly sensitive screening assays, such as ELISA for serum antibody.
Universal screening is rarely actualized before and during pregnancy.	Provide professional training to general practitioners.
	Work with obstetricians and select highly sensitive HCV antibody tests to promote testing for women of childbearing age or pregnancy.
High-income countries
Injection drug use (IDU) and Men who have sex with men (MSM) remain the key risk factor for new hepatitis C infections.	Promote HCV testing in PWID and increase access to harm reduction programs, such as needle exchange programs.
	Implement national HCV register to track progress and yearly screening.
Chances for screening are plentiful but no adequate linkage to care for sufficient treatment.	Take a holistic approach to HCV elimination with coordinated screening, linkage-to-care and treatment efforts.