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Background: Treating HCV in people with hemophilia not only prevents the development of ESLD and HCC, but it also greatly increases the quality of life for people living with hemophilia. There are many obstacles in reaching the WHO goal of globally eradicating HCV by the year 2030., mainly its scale, complexity and implementation. That is why many countries have implemented a micro-elimination strategy: a pragmatic elimination approach in populations with the most efficacy. The aim of this publication is to present the morbidity and mortality rates, the clinical course and treatment outcomes of chronic HCV infection in PWH, as well as to show an example of a successfully conducted HCV micro-elimination strategy among people with hemophilia in the Province of Vojvodina. Methods: A retrospective, single-center study, performed using medical documentation of all registered PWH in the Clinical center of Vojvodina from 1994. until 2020. It included 74 hemophilia patients, out of which 32 were patients with hemophilia and chronic HCV infection. Results: The mean age of HCV positive PWH was 42.3 years, with the duration of infection of 30-35 years. Co-infection with HIV was observed in 6.25% of cases. Furthermore, 18.75% of patients had spontaneous HCV elimination and 75% patients were treated with antiviral protocols. Cirrhosis developed in 21.87% with an incidence rate of 0.6 per 100 patient-years. After treatment with Pegylated IFN and ribavirin (RBV), 58.3% achieved SVR. Side effects of IFN-based therapy regiment were recorded in 20.8% of treated PWH. In 37.5% PWH, DAA protocols were administered, and these patients achieved SVR. HCV positive PWH have a statistically higher mortality rate than non-infected people with hemophilia. Among the HCV positive PWH, hemophilia-related deaths were 6.25%, and HCV-related deaths were 9.37%. Currently, in the Registry of PWH in Vojvodina, there are no patients with active HCV infection. Conclusion: The micro-elimination strategy in subpopulation of PWH was successfully implemented in the Province of Vojvodina in close collaborations of hematologist and infectious diseases specialist.

Introduction. Hepatitis A virus is the most common cause of acute viral hepatitis, and in people over 25 years of age the disease may have different degrees of severity. Even though hepatitis A virus infection was long believed to be transmitted strictly by fecal-oral route, now this virus is classified among sexually transmitted diseases. Homosexual population, especially those positive for human immunodeficiency virus, is at the greatest risk of hepatitis A virus infection. Case 1. A twenty-six-year-old male homosexual was admitted with clinical and laboratory findings of acute hepatitis. The patient tested positive for enzyme-linked immunosorbent assay immunoglobulin M antibodies to hepatitis A virus and human immunodeficiency virus antibodies, and later on human immunodeficiency virus infection was confirmed by polymerase chain reaction test. After the discharge, the antiretroviral therapy was initiated. Case 2. A twenty-seven-year-old male homosexual was transferred to our clinic from the Regional Hospital, where he was hospitalized due to acute hepatitis A virus infection, after a positive serological test for anti-human immunodeficiency virus antibodies. Human immunodeficiency virus infection was confirmed by polymerase chain reaction test, and upon discharge, antiretroviral therapy was initiated. Conclusion. In order to take the most effective preventive measures, it is very important to identify individuals and groups at high risk of coinfection with human immunodeficiency virus and hepatitis A virus. Timely vaccination against hepatitis A virus among people living with human immunodeficiency virus is recommended and therefore it is necessary to design effective strategies for education of groups at risk.

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