FRI-225-Universal access to direct-acting antivirals treatment is not not enough to prevent late stage presentation of hepatitis C infection

Cabezas, Joaquín; Vázquez, Inmaculada Fernández; Llerena, Susana; Carrión, J.A.; Moya, Adolfo Gallego; Lens, Sabela; Panero, José Luis Calleja; Pascasio, J.M.; Prieto, M.; Gea, Francisco; Moreno-Planas, J.M.; Carmona, Isabel; Rincón, Diego; Badia-Aranda, Esther; Diago, M.; Morillas, Rosa; Turnés, Juan; Arenas, Juan; Arencibía, Ana; Crespo, Javier

doi:10.1016/s0618-8278(19)30970-3

Cited by 5 publications

(4 citation statements)

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“…• Diagnóstico de la hepatitis C en fases avanzadas de la enfermedad. Datos actuales recientemente comunicados en nuestro país demuestran que el 20% de los pacientes inician su tratamiento en fases avanzadas de la enfermedad (41). Además, se produciría un agotamiento diagnóstico, previsto para el año 2022, causa actual -y sobre todo futura-de que los nuevos diagnósticos sin un cribado se efectúen en fases avanzadas de la enfermedad (42,43).…”

Section: La Edad Como Factor De Riesgo De Infección Por El Vhcunclassified

Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH)

Crespo

Albillos

Buti³

et al. 2019

Gastroenterología y Hepatología (English Edition)

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Section: La Edad Como Factor De Riesgo De Infección Por El Vhcunclassified

Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH)

Crespo

Albillos

Buti³

et al. 2019

Gastroenterología y Hepatología (English Edition)

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“…Since then, in the European region, many of those policy-driven barriers have been worked on, lowered or are no longer in place, as in Switzerland, where universal access to testing and treating is available. Nevertheless, our findings imply that unrestricted access, reimbursement of the costs and a well-tolerable treatment are not the overall conclusive factors for eliminating HCV [31] because still existing barriers to detecting affected persons and linking them to care leave a significant number of patients untreated and at risk of LP. Customised and comprehensive screening schemes are missing in many regions, including Switzerland.…”

Section: Discussionmentioning

confidence: 99%

Late presentation for hepatitis C treatment: prevalence and risk factors in the Swiss Hepatitis C Cohort

Brunner,

Grischott,

Bruggmann

2024

European Journal of Gastroenterology &Amp; Hepatology

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Objective Patients with ‘late presentation’ (LP) of chronic hepatitis C infection (HCV) have already developed advanced liver disease before receiving direct-acting antiviral (DAA) treatment. Even after successful treatment, the risk of morbidity and premature death remains elevated, leading to an unnecessary disease burden. This study aimed to assess the prevalence of LP within the prospective observational Swiss Hepatitis C Cohort (SCCS) and evaluate risk factors as determinants of LP. Methods Treatment-naïve participants of SCCS who received DAA treatment between 2014 and 2019 were included. Demographic, clinical and behavioural data were compared between the LP and non-LP strata. LP prevalence was calculated over time and by year. LASSO regression was used to identify potential risk factors for LP, and odds ratios were calculated by refitting logistic regression models. Results In this explorative, retrospective case–control study using data of n = 5829 SCCS members, a total of 21.3% received their first HCV treatment. The cumulative LP prevalence decreased from mid-2015 and stabilised at 46.5% (n = 579) by the end of 2019. Male gender, higher age and a history of alcohol overuse were associated with a higher risk of LP. Conclusion Despite the study’s limitations, LP prevalence was higher than anticipated, considering Switzerland’s availability period and universal access to DAAs. Therefore, any HCV LP should be viewed as a healthcare system failure, primarily in high-income economies. As LP is directly linked to the disease burden, it must be included as a mandatory parameter in surveillance response systems of HCV elimination programs.

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“…14,18 Recent Spanish data showed that 20% of patients began their treatment in advanced disease stages. 19 We identified three patients with hepatocellular carcinoma lost to clinical follow-up, highlighting the importance of retrieving patients with chronic HCV in the early stages.…”

Section: Discussionmentioning

confidence: 99%

HCV microelimination strategies: An interventional study in diagnosed patients without access to the system

Veloz

Bellido

Ruíz

et al. 2021

Liver International

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Hepatitis C virus (HCV) one-step diagnosis improves recovery in patients with active infection. However, patients with previous anti-HCV+ may be excluded. We aimed to identify and retrieve non-referred or lost-to-follow-up HCV-infected patients. All anti-HCV+ patients seen in our hospital between 2013 and 2018 were included.In the first phase, we identified anti-HCV+ patients who were not referred to the Gastroenterology Unit (GU) or lost-to-follow-up. In the second phase, recovered patients were invited for a one-step visit for liver evaluation. A total of 1330 anti-HCV+ patients were included: 21.7% had not been referred to GU, and 23.1% were lostto-follow-up. In the second phase, 49.6% of patients were contacted, and 92.8% attended a medical consultation: 62.7% had active infection, 92.2% were treated, and 86.5% achieved SVR (ITT). We concluded that screening microbiological data and referring unidentified patients with active HCV infection directly to specialists is an effective tool in achieving HCV microelimination.

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FRI-225-Universal access to direct-acting antivirals treatment is not not enough to prevent late stage presentation of hepatitis C infection

Cited by 5 publications

References 0 publications

Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH)

Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH)

Late presentation for hepatitis C treatment: prevalence and risk factors in the Swiss Hepatitis C Cohort

HCV microelimination strategies: An interventional study in diagnosed patients without access to the system

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