Kim Thanh V, Le Duc H, Dao Diem V B, Pham Trang Ngoc Doan, Mize Gary W, Phan Loc T B, Nguyen Dan X, Ngo Thi-Thuy-Dung, Gish Robert G, Lee William M, Trang Amy, Le Anh N, Chen Moon, Phan Hai T, Nguyen Binh T, Tang Hong K, Dao Doan Y
Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.
Vietnam Viral Hepatitis Alliance, Reston, VA, USA.
Lancet Reg Health West Pac. 2022 Jul 9;27:100524. doi: 10.1016/j.lanwpc.2022.100524. eCollection 2022 Oct.
A baseline of hepatitis C virus (HCV) burden and other HCV epidemiological profiles is necessary for HCV micro-elimination in Ho Chi Minh City (HCMC), Viet Nam. This study aimed to determine HCV exposure and prevalence of HCV viremia as well as the proportion of HCV testing and treatment uptake among participants.
From 2019 to 2020, the probability proportionate to size sampling method was deployed to representatively invite approximately 20,000 adults (18 or older) throughout HCMC to free screening and linkage to care for HCV.
In HCMC, the weighted prevalence of anti-HCV was 1·3% (95% CI, 1·1%-1·6%). Individuals born from 1945 to 1964 had the anti-HCV prevalence of 3·6% (95% CI, 3·0%-4·2%) and represented 40·4% of all HCV cases. There were wide variations in anti-HCV prevalence in HCMC, including variations between districts, risk factors, and socioeconomic statuses. A baseline HCV continuum of care for the city demonstrated that only 28·5% (85/298, 95%CI 23·4-33·7%) of persons with anti-HCV (+) were aware of their HCV status, with 77.6% (66/85, 95%CI 68·8-86·5%) diagnosing HCV incidentally, 82·7% (62/75, 95%CI 74·1-91·2%) initiating anti-HCV therapy, and 53.6% (30/56, 95%CI 40·5-66·6%) achieving HCV cures.
There remains a considerable disease burden of HCV in HCMC of which a significant proportion was in the age group born between 1945 to 1964. Additionally, there were significant gaps in HCV awareness, screening, and access to care in the community in Viet Nam. Thus, future interventions must have pragmatic targets, be tailored to the local needs, and emphasise screening.
This work was supported by investigator-sponsored research grants from Gilead Sciences Inc. (Grant No: IN-US-987-5382); Roche Diagnostic International Ltd. (Grant No. SUB-000196); and in-kind donations from Abbott Diagnostic Viet Nam; Hepatitis B Foundation; Medic Medical Center, Viet Nam; Johns Hopkins University School of Medicine's Center of Excellence for Liver Disease in Viet Nam; and the Board of Directors, Viet Nam Viral Hepatitis Alliance (V-VHA).
对于越南胡志明市的丙型肝炎病毒（HCV）微观消除而言，了解HCV负担基线及其他HCV流行病学特征很有必要。本研究旨在确定参与者中HCV暴露情况、HCV病毒血症患病率以及HCV检测和治疗接受比例。
2019年至2020年，采用按规模大小概率抽样法，有代表性地邀请胡志明市约20000名成年人（18岁及以上）接受HCV免费筛查及护理衔接。
在胡志明市，抗-HCV加权患病率为1.3%（95%CI，1.1%-1.6%）。1945年至1964年出生的个体抗-HCV患病率为3.6%（95%CI，3.0%-4.2%），占所有HCV病例的40.4%。胡志明市抗-HCV患病率存在很大差异，包括不同区之间、危险因素以及社会经济地位之间的差异。该市HCV连续护理基线显示，抗-HCV（+）者中只有28.5%（85/298，95%CI 23.4-33.7%）知晓自己的HCV状况，其中77.6%（66/85，95%CI 68.8-86.5%）为偶然诊断出HCV，82.7%（62/75，95%CI 74.1-91.2%）开始接受抗-HCV治疗，53.6%（30/56，95%CI 40.5-66.6%）实现HCV治愈。
胡志明市HCV疾病负担仍然相当大，其中很大一部分集中在1945年至1964年出生的年龄组。此外，越南社区在HCV知晓、筛查及获得护理方面存在显著差距。因此，未来的干预措施必须有切实可行的目标，根据当地需求进行调整，并强调筛查。
本研究得到吉利德科学公司（资助编号：IN-US-987-5382）、罗氏诊断国际有限公司（资助编号：SUB-000196）的研究者发起研究资助，以及雅培诊断越南公司、乙肝基金会、越南医学医疗中心、越南约翰霍普金斯大学医学院肝病卓越中心和越南病毒性肝炎联盟董事会的实物捐赠。
