Skrzat-Klapaczyńska Agata, Antoniak Sergii, Antonyak Svitlana, Protopapas Konstantinos, Papadopoulos Antonios, Maric Daniela, Lakatos Botond, Verhaz Antonija, Zlamal Milan, Bartovska Zofia, Stefanovikj Milena, Dragovic Gordana, Harxhi Arjan, Jilich David, Aimla Kerstin, Cojuhari Lilia, Kowalska Justyna, Begovac Josip
MD, PhD, Department of Adults' Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, Warsaw, Poland.
MD, Gromashevsky Institute of Epidemiology and Infectious Diseases within NAMS of Ukraine, Kyiv, Ukraine.
Germs. 2025 Jun 30;15(2):144-156. doi: 10.18683/germs.2025.1464. eCollection 2025 Jun.
The implementation of nationwide viral hepatitis C elimination programs is challenging in Central and Eastern European countries (CEEC). It is reasonable to start by targeting specific populations, such as people living with HIV (PLWH), who are at higher risk of acquiring HCV or developing HCV-related complications.
Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of infectious diseases from 26 countries in the region. Between April 26 and June 23 2023, the group performed an on-line survey consisting of 32 questions. The questionnaire assessed the status of HCV micro-elimination in 2022.
Twelve HIV centers from 11 countries responded: Albania, Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Greece, Hungary, Macedonia, Moldova, Serbia and Ukraine. All centers screen for HCV antibody all PLWH at entry into care. The seroprevalence of anti-HCV was <5% in 5 centers (Albania, Croatia, Serbia, North Macedonia and Hungary), 30.2% in Estonia and 29% in Ukraine, Greece and Moldova had high seroprevalence as well, 15.3% and 15.6% respectively. The prevalence of HCV viremia in antibody-positive PLWH was very high in Greece (85%), while in most other treatment centers it ranged from 4.2% to 38.2%. There is also a screening policy of annual HCV-testing of HCV-antibody negative persons in all centers by either testing all PLWH or those considered at risk. Direct-acting antiviral agents (DAA) were not available in one country (Albania). Among PLWH who entered care in 2022, nine out of 12 ECEE centers reported cases of HCV/HIV coinfection, with five centers indicating that at least 50% of these individuals were HCV-viremic.
HCV screening in PLWH followed by access to DAA treatments were available in all but one center. Microelimination of HCV in PLWH in the majority of surveyed HIV treatment centers in CEEC has not been achieved and efforts to reach this goal need to be strengthened.
在中东欧国家（CEEC）实施全国性丙型肝炎消除计划具有挑战性。以特定人群为目标展开行动是合理的，比如感染艾滋病毒的人（PLWH），他们感染丙肝病毒或出现丙肝相关并发症的风险更高。
中东欧网络小组的欧洲指南由该地区26个国家的传染病领域专家组成。2023年4月26日至6月23日期间，该小组开展了一项包含32个问题的在线调查。问卷评估了2022年丙肝微消除的状况。
来自11个国家的12个艾滋病毒中心做出了回应：阿尔巴尼亚、波斯尼亚和黑塞哥维那、克罗地亚、捷克共和国、爱沙尼亚、希腊、匈牙利、马其顿、摩尔多瓦、塞尔维亚和乌克兰。所有中心在艾滋病毒感染者开始接受治疗时都会对其进行丙肝抗体筛查。5个中心（阿尔巴尼亚、克罗地亚、塞尔维亚、北马其顿和匈牙利）的抗丙肝病毒血清阳性率低于5%，爱沙尼亚为30.2%，乌克兰、希腊和摩尔多瓦的血清阳性率也很高，分别为29%、15.3%和15.6%。在希腊，抗体阳性的艾滋病毒感染者中丙肝病毒血症的患病率非常高（85%），而在大多数其他治疗中心，这一比例在4.2%至38.2%之间。所有中心都有一项针对丙肝抗体阴性者的年度丙肝检测筛查政策，要么检测所有艾滋病毒感染者，要么检测那些被认为有风险的人。有一个国家（阿尔巴尼亚）没有直接抗病毒药物（DAA）。在2022年开始接受治疗的艾滋病毒感染者中，中东欧12个中心中有9个报告了丙肝/艾滋病毒合并感染病例，其中5个中心表示这些感染者中至少50%为丙肝病毒血症患者。
除一个中心外，所有中心都对艾滋病毒感染者进行丙肝筛查，并提供直接抗病毒药物治疗。中东欧大多数接受调查的艾滋病毒治疗中心尚未实现对艾滋病毒感染者的丙肝微消除，需要加强为实现这一目标所做的努力。
