Hepatitis C virus screening in the 1969–1989 birth cohort: Is not enough!

Viganò, Mauro; Cerini, Federica; Ridolfo, Sofia; Rumi, Maria Grazia

doi:10.1111/liv.15316

Cited by 5 publications

(8 citation statements)

References 4 publications

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“…Another point raised by our study is the high percentage of subjects with positive anti‐HCV but negative HCV–RNA values (71.7%). This data is in line with other reports, as rates of undetectable HCV–RNA in anti‐HCV positive subjects identified by opportunistic screening programs in recent studies vary between 64% and 82%, 11–14 to be lower in individuals unaware of their status (0%–33%) 8,17,12–14 . Although patients with a sustained virological response (SVR) should not have been included in our study, we cannot exclude that some of them did still participate to this screening program.…”

Section: Discussionsupporting

confidence: 91%

“…Another point raised by our study is the high percentage of subjects with positive anti-HCV but negative HCV-RNA values (71.7%). This data is in line with other reports, as rates of undetectable HCV-RNA in anti-HCV positive subjects identified by opportunistic screening programs in recent studies vary between 64% and 82%, [11][12][13][14] to be lower in individuals unaware of their status (0%-33%). in Milan, 4 out of 5 (80%) positive subjects initially affirming to be unaware of their HCV status declared to have already been treated…”

Section: Characteristicssupporting

confidence: 92%

“…In fact, only two studies targeted people owning to the 1969–1989 birth cohort and reported rates of active HCV infection of 0.05% and 0.07%, respectively. Results from those studies were comparable, despite potential differences in the target population: “healthy” individuals undergoing anti‐COVID‐19 vaccination in the first study versus people hospitalized for any reason in the second one 8,14 . Other studies conducted in unselected people (any age) reported prevalence of active HCV infection of 0.5% and 0.7% in hospitalized subjects, 11,12 and of 0.07% in those undergoing anti‐SARS‐CoV‐2 testing or vaccination 13 .…”

Section: Discussionmentioning

confidence: 87%

“…Results from those studies were comparable, despite potential differences in the target population: "healthy" individuals undergoing anti-COVID-19 vaccination in the first study versus people hospitalized for any reason in the second one. 8,14 Other studies conducted in unselected people (any age) reported prevalence of active HCV infection of 0.5% and 0.7% in hospitalized subjects, 11,12 and of 0.07% in those undergoing anti-SARS-CoV-2 testing or vaccination. 13 Not unexpectedly, taking together all these studies reveal prevalence of viraemic patients lower than that reported in studies conducted before 2019, [15][16][17] TA B L E 3 Main patients' characteristics and screening outcome according to recruitment setting and birth cohort.…”

Section: Discussionmentioning

confidence: 99%

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A territory‐wide opportunistic, hospital‐based HCV screening in the general population from northern Italy: The 1969–1989 birth‐cohort

D'Ambrosio,

Piccinelli,

Beccalli

et al. 2023

Liver International

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Background and AimThe World Health Organization (WHO) goal of Hepatitis C Virus (HCV) elimination by 2030 rose awareness about the need of screening plans, worldwide. In Italy, graduated screening starting from people born in 1969–1989 might be the most‐effective strategy. We performed an opportunistic HCV screening study in the general population attending health facilities in Lombardy region, Northern Italy.MethodsThis is a prospective, multicenter, territory‐wide, opportunistic study supported by the Regional Government of Lombardy, Italy. Between June 2022 and December 2022, all subjects born in 1969–1989, hospitalized or accessing blood collection centres were offered anti‐HCV and HCV–RNA tests. Patients with known anti‐HCV positivity and/or previous anti‐HCV treatment were excluded. Demographic features were uploaded into a regional web‐based platform.ResultsIn total, 120 193 individuals were screened in 75 centres. Mean age was 44 (±6) years, 65.2% were females, 83.7% were tested at blood collection centres. Anti‐HCV tested positive in 604 (0.50%) subjects: mean age 47 (±5), 51.1% females. HCV seroprevalence was higher in males (p < 0.00001), elderly (p < 0.00001) and in‐ vs. outpatients (p = 0.0009). HCV–RNA was detectable in 125 out of 441 (28.3%) anti‐HCV positive subjects. Actively infected patients were 46 (±6) years old, mainly males (56.8%). The overall prevalence of active HCV infection was 0.10%, higher in elderly (p = 0.0003) and in in‐patients (p = 0.0007). Among 93 HCV–RNA positive patients, the median age was 48 years, 58% males, 62% Italian born, median HCV–RNA levels were 6,1 log IU/mL, liver stiffness measurement (LSM) values 5.5 (3.1–29.9) kPa and ALT levels 48 U/L.ConclusionsThe prevalence of active HCV infection in the 1969–1989 population attending health facilities in Lombardy was low. Most viremic patients were Italian‐born, with mild liver disease but high‐HCV–RNA levels. Due to the higher prevalence in the elderly, the extension of such opportunistic screening programs to lower birth cohorts would be warranted.

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Section: Discussionsupporting

confidence: 91%

Section: Characteristicssupporting

confidence: 92%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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A territory‐wide opportunistic, hospital‐based HCV screening in the general population from northern Italy: The 1969–1989 birth‐cohort

D'Ambrosio,

Piccinelli,

Beccalli

et al. 2023

Liver International

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“…Meanwhile (2021-2022), as was previously suggested and recommended [7,32,33], the pandemic itself was exploited to the advantage of HCV testing, that is to say SARS-CoV-2 testing or vaccination were leveraged for a concomitant HCV screening in the general population. Programs of this type were conducted in northern and southern Italy and documented a lower-than-expected prevalence of infection in the target age group [34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Country-Wide HCV Elimination Strategies Need to Reach Older Patients in the General Population: The Italian Experience

Torre,

Coppola,

Masarone

et al. 2023

Viruses

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HCV infection is still a major burden worldwide, and most countries are not on track to meet the WHO 2030 elimination goal. The current challenge is to identify individuals to be treated. In this study, we will describe the trend of new DAA prescriptions and the changes over time in terms of the characteristics of patients starting antiviral therapy in our unit. Data of 1646 hepatitis C patients who started therapy during the period of 2015–2022 regarding annual number of prescriptions, age, gender, nationality, HCV genotype, provenance, and liver disease severity were analyzed. We observed a peak in the number of new prescriptions in 2018 and a downward trend starting in 2019. Patients from the general population, centers for addictions, and prison differed significantly. The mean age in the general population remained above 60 years, the percentage of patients from centers for addictions and prison increased and, after 2016, there was no significant change in the percentage of patients with F3–F4 fibrosis. As HCV screening and linkage-to-care pathways seem to be already well implemented and successful in centers for addictions and in prisons, efforts need to be focused on those of older age in the general population. To carry this out, the more structured involvement of different health professionals must be figured out.

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Screening for hepatitis C at the time of the pandemic: Need to adjust the shot

Torre

Coppola²,

Masarone

et al. 2022

Liver International

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To the Editor, We have read with interest the recent articles by D'Ambrosio et al. and by Viganò et al. in which they reported data on the prevalence of HCV infection in the general population either by combined screening of HCV and SARS-CoV-2 vaccination, 1 or in hospitalized patients for any reason. 2 A prevalence of active HCV infection in the 1969-1989 cohort of 0.05% was reported in the combined screening and of 0.07% (considering who was unaware) when hospitalized patients were tested. Similarly, we reported results of a hepatitis C screening in the general population during SARS-CoV-2 vaccination conducted in the period May-July 2021 in the province of Salerno. 3Out of 1952 people screened for HCV after vaccination, five HCV-Ab-positive people (0.25%) were found and of these only one female, 46 years old, of Italian nationality with active infection (0.05%), aware of her condition and not previously treated, was identified.

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Hepatitis C virus screening in the 1969–1989 birth cohort: Is not enough!

Cited by 5 publications

References 4 publications

A territory‐wide opportunistic, hospital‐based HCV screening in the general population from northern Italy: The 1969–1989 birth‐cohort

A territory‐wide opportunistic, hospital‐based HCV screening in the general population from northern Italy: The 1969–1989 birth‐cohort

Country-Wide HCV Elimination Strategies Need to Reach Older Patients in the General Population: The Italian Experience

Screening for hepatitis C at the time of the pandemic: Need to adjust the shot

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