Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2024 May;136(9-10):278-288. doi: 10.1007/s00508-023-02275-4. Epub 2023 Sep 29.
Micro-elimination projects targeted to specific hepatitis C virus (HCV) risk populations have been successful. Systematic identification of persons with HCV viremia, regardless of risk group, based on already available laboratory records may represent an effective macroelimination approach to achieve global HCV elimination.
Persons with a last positive HCV-RNA PCR result between 2008-2020 in the reference virology laboratories in eastern Austria were identified. First, (i) we described their demographic characteristics, (ii) we systematically recalled persons to the respective centers and (iii) started antiviral treatment if HCV-RNA viremia was confirmed, and (iv) recorded sustained virologic response (SVR). This interim report includes the preliminary results from 8 participating centers.
During the study period 22,682 persons underwent HCV-RNA PCR testing, 11,216 (49.4%) were positive at any point in time, and 6006 (26.5%) showed detectable HCV-RNA at the last PCR test, suggesting ongoing HCV viremia. At the time of this interim report, 2546/6006 HCV-RNA PCR(+) persons were evaluated: 443/2546 (17.4%) had died, 852/2546 (33.5%) had invalid contact data, and 547/2546 (21.5%) had achieved SVR between data retrieval and recall. Contact could be established in 236/704 (33.5%) of the remaining target population with 97/236 (41.1%) presenting at the clinic for treatment evaluation. Ultimately, 71/236 (30.1%) started antiviral treatment and SVR was documented in 47/71 (66.2%).
This ELIMINATE project based on systematic assessment of HCV-RNA PCR-records, identified 6006 persons with potential persisting HCV viremia. Invalid contact data and missed visits for treatment evaluation were the main barriers towards HCV elimination within this project. Importantly, many subjects with HCV viremia lost to follow-up were successfully linked to care and started antiviral treatment.
针对特定丙型肝炎病毒（HCV）风险人群的微消除项目已取得成功。基于现有的实验室记录，系统地识别所有 HCV 病毒血症患者，而不考虑其风险群体，这可能代表实现全球 HCV 消除的一种有效宏观消除方法。
在奥地利东部的参考病毒学实验室，确定 2008-2020 年间最后一次 HCV-RNA PCR 检测结果阳性的患者。首先，（i）描述他们的人口统计学特征，（ii）系统地召回患者到相应的中心，（iii）如果 HCV-RNA 病毒血症得到确认，开始抗病毒治疗，（iv）记录持续病毒学应答（SVR）。本中期报告包括 8 个参与中心的初步结果。
在研究期间，22682 人接受了 HCV-RNA PCR 检测，11216 人（49.4%）在任何时间点均为阳性，6006 人（26.5%）在最后一次 PCR 检测中检测到 HCV-RNA，提示持续存在 HCV 病毒血症。在本中期报告时，对 6006 名 HCV-RNA PCR（+）患者进行了评估：443 人（17.4%）死亡，852 人（33.5%）联系信息无效，547 人（21.5%）在数据检索和召回期间获得了 SVR。在剩余的目标人群中，有 236 人（33.5%）可以建立联系，其中 97 人（41.1%）到诊所接受治疗评估。最终，236 人中有 71 人（30.1%）开始接受抗病毒治疗，71 人中有 47 人（66.2%）获得 SVR。
本项目基于对 HCV-RNA PCR 记录的系统评估，确定了 6006 名可能持续存在 HCV 病毒血症的患者。联系信息无效和未能就诊接受治疗评估是本项目中实现 HCV 消除的主要障碍。重要的是，许多失去随访的 HCV 病毒血症患者已成功纳入治疗并开始接受抗病毒治疗。
