Implementation of HCV screening in the 1969–1989 birth‐cohort undergoing COVID‐19 vaccination

Abstract

Background and Aim The World Health Organization (WHO) goal of hepatitis C virus (HCV) elimination by 2030 relies on the scaling‐up of both identification and linkage to care of the infected population, worldwide. In Italy, the estimated burden of HCV carriers who are unaware of their infection amounts to 200 000 persons, a projection that reinforces the need for broadening population access to effective screening programmes. Methods A pivotal screening programme targeting subjects born between 1969 and 1989 has been conducted in Lombardy, Northern Italy, where point‐of‐care (POC) testing was offered for free concomitantly to COVID‐19 vaccination. Results Amongst 7219 subjects born between 1969 and 1989 who underwent HCV screening through POC, 7 (0.10%) subjects tested anti‐HCV positive: 5 (0.07%) had confirmed anti‐HCV positivity (Table 1) and 4 of them (0.05%) were HCV‐RNA positive by standard confirmation tests. Conclusions This pivotal study demonstrated the feasibility of a POC‐based anti‐HCV screening programme in young adults undergoing COVID‐19 vaccination. The prevalence of HCV infection in subjects born in the 1969–1989 cohort in Italy seems to be lower than previously estimated. Whether the extension of this programme to subjects born before 1969 could lead to improved screening effectiveness should be a matter of debate.

HCV point of care screening in people tested for SARS‐CoV‐2 in a social‐housing neighbourhood of Milan, Italy

“…In their study, D'Ambrosio et al 2 reported a prevalence of 0.10% for HCV Ab and 0.05% for HCV‐RNA, a lower proportion than the one we found. This could be expected and it is mainly explained by the demographic composition of the population selected for the screening: our study population was older (median 64 years) when compared to that of D'Ambrosio et al (range 32–52 years).…”

“…We read with interest the Editorial by Kondili et al 1 about the potential pitfalls found in studies in which SARS‐CoV‐2 testing is combined with point‐of‐care‐testing (POCT) HCV screening. 2 , 3 We do agree that the representativeness of the target population could be a problem in such pilot studies. In addition, it could be speculated that socioeconomically deprived people could face barriers to being engaged in HCV and SARS‐CoV‐2 combined screening programs.…”

“…This could be expected and it is mainly explained by the demographic composition of the population selected for the screening: our study population was older (median 64 years) when compared to that of D'Ambrosio et al (range 32–52 years). 2 In fact, we selected subjects >39 years older, as age is itself a risk factor for HCV infection, considering our limited RICTs supply.…”

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

“…1 Recently, the journal published a Brief Report 2 and a Research Letter 3 reporting the data on the screening for HCV infection in the latter group of subjects undergoing the SARS-CoV-2 vaccination. D'Ambrosio et al 2 in 7219 subjects born between 1969 and 1989 undergoing SARS-CoV-2 vaccination in Lombardy (north of Italy) that agreed to be tested for anti-HCV, identified 5 (0.07%) subjects unaware of their anti-HCV positivity, 4 of them (0.05%) HCV RNA positive. Torre et al 3 among 920 subjects between 31 and 50 years of age undergoing SARS-CoV-2 vaccination in Campania (south of Italy) found none with an unknown active HCV infection.…”

Combined COVID-19 vaccination and hepatitis C virus screening intervention in marginalised populations in Spain

“…7 A programme in Lombardy, Italy, used an integrated approach similar to ours whereby they offered HCV screening to 1969-1989 birth-cohort subjects undergoing COVID-19 vaccination using PoCT and found that four (0.06%) of 7219 participants were HCV-RNA + . 30 Another programme in Salerno, Italy, offered HCV screening via PoCT to anyone (17 years or older)…”