Hepatitis C Screening in Community-Based Voluntary Counselling and Testing Services in Europe: An Observational Study from the COBATEST Network 2014–2018

  • Anna ConwayEmail author
  • Laura Fernàndez-López
  • Juliana Reyes-Urueña
  • Jordi Casabona
  • COBATEST Study Group
Original Paper


The COBATEST Network links community-based voluntary counselling and testing (CBVCT) services in the European region and collects testing data using standardised data collection tools. This study aims to describe the population being screened for anti-HCV antibodies in the COBATEST Network and identify risk factors associated with a reactive HCV screening test result in the period 2014–2018. Clients aged > 16 screened for HCV in the period 2014–2018 at one of the Network’s CBVCT services were included in the study. In the 5 year period, 7426 clients were screened for HCV in 22 centres in 10 countries and anti-HCV antibodies were detected in 113 (1.5%). The majority of people screened were aged 25–44, men who have sex with men (MSM), not HIV+ , not reporting a history of injecting drug use or sex work. Detection of anti-HCV antibodies was associated with being HIV + MSM (aOR 9.1, 95% CI 3.8; 21.8 compared to HIV-clients) and being a person who injects drugs (PWID, aOR 28.1, 95% CI 17.6; 45.0, compared to people with no history of injecting drug use). This study demonstrates that HIV-MSM with no history of injection drug use are using CBVCT services for HCV screening, but reactive screening test is associated with being HIV+ or PWID. The integration of HCV screening into the CBVCT service model may widen access to testing for populations that may otherwise not be tested.


Hepatitis C Screening Community networks Europe 



We thank the following for taking the time to review the manuscript: Cristina Agusti Benito (CEEISCAT), Julia Becerril Gascón (CASDA—Asociació Ciutadana Contra la SIDA), Valentin Blaison (ExAequo), Patricia Colomera (CAS/ARDS Lluís Companys), Lella Cosmaro (LILA Milano), Sabrina Penon (LILA Milano), Heidi Slavin (AIDS Fondet). We thank all organisations who form part of the COBATEST Network and carry out testing activities throughout the year (organisations whose data is included in this study are marked with an asterix): Associació Antisida Lleida (Spain), Abraco (Portugal), Asociación Comunitaria Anti Sida de Girona (Spain), Associació Ciutadana Antisida de Catalunya (Spain), Associació Ciutadana Alacant i província de persones afectades VIH (Spain)*, Asociación Ciudadana Cántabra Anti Sida (Spain), Actuavallès (Spain)*, Adhara (Spain), AIDES (France), AIDS Fondet (Denmark)*, AIDS Hilfe Wien (Austria)*, Alliance Global (Ukraine)*, Àmbit Prevenció (Spain)*, ARAS (Romania)*, AIDS Solidarity Movement Cyprus (Cyprus), Asociación Somos LGT (Spain)*, Asocijacija Duga (Serbia), Assexora’Tgn (Spain)*, Associació Lambda (Spain)*, AVACOS-H (Spain)*, Baltic HIV Associati (Latvia)*, CAS/ARDS Lluís Companys (Spain)*, Asociación Ciudadana Contra el SIDA Castellón—CASDA (Spain)*, Comité Ciudadano Antisida de Asturias (Spain), Centre Jove d’Antico (Spain), Checkpoint Milano (Italy), Creu Roja Tarragona (Spain), Czech AIDS Help (Czech Republic), Demetra (Lithuania)*, Deutsche AIDS Hilfe (Germany), Ex Aequo (Belgium)*, Fondazione LILA Milano (Italy)*, Fulcrum (Ukraine)*, Gais Positius (Spain)*, GAT Portugal (Portugal), GenderdocM (Moldova), Health Without Borders (Bulgaria), HERA (Macedonia), HUHIV (Croatia), Iskorak (Croatia), LaSky (Russia), Legebitra (Slovenia)*, Mujer Gades (Spain), National AIDS Centre (Poland), OMSIDA (Spain)*, StopSida (Spain), Swiss Checkpoints (Switzerland).


The COBATEST Network received grants from Gilead Sciences Europe Ltd (2017) and the Health Programme of the European Union (2018–2019) during the study.

Compliance with Ethical Standards

Conflict of interest

There are no conflict of interest for any author.

Supplementary material

10900_2019_780_MOESM1_ESM.xlsx (17 kb)
Supplementary material 1 (XLSX 17 kb)


  1. 1.
    European Centre for Disease Prevention and Control. (2019). Annual epidemiological report for 2017Hepatitis C.Google Scholar
  2. 2.
    World Health Organisation. (2016). Combating hepatitis B and C to reach elimination by 2030.Google Scholar
  3. 3.
    Heffernan, A., Cooke, G. S., Nayagam, S., Thursz, M., & Hallett, T. B. (2019). Scaling up prevention and treatment towards the elimination of hepatitis C: A global mathematical model. The Lancet,6736(18), 1–12. Scholar
  4. 4.
    Shehata, N., Austin, T., Ha, S., & Timmerman, K. (2018). Barriers to and facilitators of hepatitis C virus screening and testing: A scoping review. Can Commun Dis Rep,44(6), 166–172.CrossRefGoogle Scholar
  5. 5.
    Ross, M. W., Berg, R. C., Schmidt, A. J., Hospers, H. J., Breveglieri, M., Furegato, M., et al. (2013). Internalised homonegativity predicts HIV-associated risk behavior in European men who have sex with men in a 38-country cross-sectional study: Some public health implications of homophobia. British Medical Journal Open,3(2), 1–11. Scholar
  6. 6.
    Conway, A., & Fernàndez López, L. (2018). COBATEST network: Community-based voluntary counselling and testing in Europe 2017 Report.Google Scholar
  7. 7.
    World Health Organization (WHO). (2017). WHO guidelines on hepatitis B and C testing.Google Scholar
  8. 8.
    Fernàndez-López, L., Reyes-Urueña, J., Agustí, C., Kustec, T., Klavs, I., & Casabona, C. (2016). The COBATEST network: A platform to perform monitoring and evaluation of HIV community-based testing practices in Europe and conduct operational research. AIDS Care,0121, 1–5. Scholar
  9. 9.
    Klavs, I., Kustec, T., Fernàndez López, L., Casabona, J., Meulbroek, M., Rios, L., & Al, E. (2014). Guidelines for data collection for monitoring and evaluation of community based voluntary counselling and testing (CBVCT) for HIV in the COBATEST network.Google Scholar
  10. 10.
    Reyes-Urueña, J., Fernàndez-Lopez, L., Montoliu, A., Conway, A., Tavosch, L., Klavs, I., … Network, T. C. (2019). Assessing the quality of routine HIV testing data in the community setting ‘COBATEST Network.’ International Journal of STD and AIDS. CrossRefGoogle Scholar
  11. 11.
    European Centre for Disease Prevention and Control. (2018a). Hepatitis B and C epidemiology in selected population groups in the EU/EEA.Google Scholar
  12. 12.
    Schatz, E., Schiffer, K., Maher, M., Harris, M., Roca, X. M., Maticic, M., et al. (2016). The Berlin Hepatitis C Manifesto: access to prevention, testing, treatment and care for people who use drugs. Hepatology, Medicine and Policy,1(1), 1–9. Scholar
  13. 13.
    MacGregor, L., Martin, N. K., Mukandavire, C., Hickson, F., Weatherburn, P., Hickman, M., et al. (2017). Behavioural, not biological, factors drive the HCV epidemic among HIV-positive MSM: HCV and HIV modelling analysis including HCV treatment-as-prevention impact. International Journal of Epidemiology,46(5), 1582–1592. Scholar
  14. 14.
    Cotte, L., Cua, E., Reynes, J., Raffi, F., Rey, D., Delobel, P., … Dat’AIDS study Group. (2018). Hepatitis C virus incidence in HIV-infected and in preexposure prophylaxis (PrEP)-using men having sex with men. Liver International. CrossRefGoogle Scholar
  15. 15.
    European Centre for Disease Prevention and Control. (2018). Public health guidance on HIV, hepatitis B and C testing in the EU/EEAAn integrated approach.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Generalitat de Catalunya Departament de SalutCentre Estudis Epidemiologics sobre les Infeccions de Transmissio Sexual i Sida de Catalunya (CEEISCAT)BarcelonaSpain
  2. 2.L’Institut de Recerca en Ciències de la Salut Germans Trias i PujolBadalonaSpain
  3. 3.CIBERESP, CIBER Epidemiologia y Salud PublicaBarcelonaSpain
  4. 4.Department of Paediatrics, Obstetrics and Gynecology and Preventive MedicineUniversitat Autonoma de BarcelonaBarcelonaSpain
  5. 5.AIDS Action Europe, c/o Deutsche AIDS-HilfeBerlinGermany

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