Coppola Carmine, Kondili Loreta A, Staiano Laura, Cammarota Simona, Citarella Anna, Aloisio Mirko Pio, Annunziata Angelo, Bernardi Francesca Futura, D'Avino Aldo, D'Orazio Michele, Fogliasecca Marianna, Fusco Mario, Pisano Federica, Vercellone Adriano, Bianco Elvira, Trama Ugo
Department of Internal Medicine, Unit of Hepatology and Interventional Ultrasonography, OORR Area Stabiese, 80054 Gragnano, Italy.
Center for Global Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
Pathogens. 2023 Jan 28;12(2):195. doi: 10.3390/pathogens12020195.
This study evaluates the feasibility of a local action program for HCV micro-elimination in highly endemic areas. Retrospective analysis: administrative and laboratory data (Local Health Unit, southern Italy) were integrated to quantize the anti-HCV-positive subjects not RNA tested and untreated HCV-infected subjects (2018-2022). Prospective analysis: all subjects admitted to a division of the LHU largest hospital (2021-2022) were tested for HCV, with linkage of active-infected patients to care. Overall, 49287 subjects were HCV-Ab tested: 1071 (2.2%) resulted positive without information for an HCV RNA test and 230 (0.5%) had an active infection not yet cured. Among 856 admitted subjects, 54 (6.3%) were HCV-Ab+ and 27 (3.0%) HCV RNA+. Of HCV-infected patients, 22.2% had advanced liver disease, highlighting the need for earlier diagnosis; 27.7% were unaware of HCV infection; and 20.4% were previously aware but never referred to a clinical center. Of these, 26% died and 74% received treatment. Our study emphasizes the value of an active HCV hospital case-finding program to enhance diagnosis in patients with several comorbidities and to easily link them to care. Our data strongly suggest extending this program to all hospital wards/access as a standard of care, particularly in highly endemic areas, to help HCV disease control and take steps in achieving the elimination goals.
本研究评估了在高流行地区开展丙型肝炎病毒（HCV）微消除本地行动计划的可行性。回顾性分析：整合行政和实验室数据（意大利南部地方卫生单位），以量化未进行RNA检测的抗HCV阳性受试者和未经治疗的HCV感染受试者（2018 - 2022年）。前瞻性分析：对地方卫生单位最大医院一个科室收治的所有受试者（2021 - 2022年）进行HCV检测，并将活动性感染患者与治疗相联系。总体而言，49287名受试者接受了HCV抗体检测：1071名（2.2%）结果呈阳性但无HCV RNA检测信息，230名（0.5%）有未治愈的活动性感染。在856名收治的受试者中，54名（6.3%）HCV抗体阳性，27名（3.0%）HCV RNA阳性。在HCV感染患者中，22.2%患有晚期肝病，凸显了早期诊断的必要性；27.7%不知道自己感染了HCV；20.4%之前知道但从未转诊至临床中心。其中，26%死亡，74%接受了治疗。我们的研究强调了积极的HCV医院病例发现计划对于加强对患有多种合并症患者的诊断并使其易于获得治疗的价值。我们的数据强烈建议将该计划扩展到所有医院病房/就诊环节，作为一种护理标准，特别是在高流行地区，以帮助控制HCV疾病并采取措施实现消除目标。
