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

Abstract 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.