Using mass media and the Internet as tools to diagnose hepatitis C infections in the general population

Am J Prev Med. 2011 Mar;40(3):345-52. doi: 10.1016/j.amepre.2010.11.019.


Background: Many individuals with hepatitis C virus (HCV) infection are undiagnosed.

Purpose: This study describes the development and the use and outcomes of a mass media campaign, combined with an Internet risk assessment and an Internet-mediated blood-testing procedure for HCV to identify individuals infected with HCV in the general population.

Methods: From April 2007 to December 2008, individuals in HCV risk groups were referred to an online, previously validated risk-assessment questionnaire at Individuals at risk could download a referral letter for a free, anonymous HCV blood test in a nonclinical setting. Test results could be obtained online, 1 week later, using a personal log-in code. Anti-HCV-positive participants were requested to visit the Public Health Service for confirmation and RNA testing. Chronically HCV-infected individuals were referred for treatment. Data were analyzed in 2009-2010.

Results: The website attracted 40,902 visitors. Of the 9653 who completed the questionnaire, 2553 were at risk for HCV (26.4%). Main reported risk factors were a blood transfusion prior to 1992 and noninjecting drug use. Of the 1480 eligible for the blood test, 420 opted for testing (28%). HCV antibodies were detected in 3.6% (n=15, 95% CI=2.1%, 5.7%); of the 12 with a chronic HCV infection, six began treatment.

Conclusions: Internet-mediated risk-based testing for HCV has proved to be a feasible and effective strategy to identify undiagnosed HCV infection in the general population. All HCV-infected individuals belonged to hard-to-reach populations. Test uptake was 28%, which is high for an online project that includes blood testing. Because Internet-mediated testing is low-cost, this strategy holds promise for future screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Feasibility Studies
  • Female
  • Hematologic Tests / methods
  • Hepacivirus / isolation & purification
  • Hepatitis C / diagnosis*
  • Hepatitis C / immunology
  • Hepatitis C Antibodies / blood
  • Humans
  • Internet*
  • Male
  • Mass Media*
  • Mass Screening / methods*
  • Middle Aged
  • Netherlands
  • Risk Assessment / methods
  • Risk Factors
  • Surveys and Questionnaires


  • Hepatitis C Antibodies