Micro-elimination of HCV as a possible therapeutic strategy: our experience and a review of literature

Bojović, Ksenija; Simonovic-Babic, Jasmina; Mijailović, Željko; Milošević, Ivana; Jovanović, Maja; Ruzic, Maja; Pasic, Tatjana Cvejic; Svorcan, Petar; Petrovic, Milena; Jordovic, Jelena

doi:10.3855/jidc.11785

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…The prevalence of HCV infection in persons with hemophilia in Serbia is thought to be around 0.37%, but until now, we did not have a definite number. 10 We can confirm that every patient with hemophilia A and B in the northern region of Serbia (the Province of Vojvodina) has been tested for anti-HCV antibodies and that the prevalence is 0.43% (43.25%). The majority of patients (87.5%) were screened for anti-HCV by the hematologist at the moment of registration in our institutions' Hemophilia Registry, unrelated to the severity of hemophilia.…”

Section: Discussionsupporting

confidence: 54%

“…In the rest of Serbia, only 57.3% of PwH have been tested for anti-HCV antibodies, and 37.5% were positive. 10 However, the exact prevalence of HCV infection (past or active) in PWH in Serbia is unknown. This "gap" in the prevalence of HCV among PwH in the different regions in Serbia supports the position of The European Hemophilia Consortium against centralized hemophilia supervision.…”

Section: Discussionmentioning

confidence: 99%

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Implementation of Microelimination Strategy in Eradication of Chronic Hepatitis C Infection in Patients With Hemophilia in the Northern Region of Serbia

Ruzic

Rajic

Fabri

et al. 2021

Mediterr J Hematol Infect Dis

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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.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Implementation of Microelimination Strategy in Eradication of Chronic Hepatitis C Infection in Patients With Hemophilia in the Northern Region of Serbia

Ruzic

Rajic

Fabri

et al. 2021

Mediterr J Hematol Infect Dis

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“…Eventually, 89% of them had their HIV status ever ascertained [87], demonstrating that, in this context, offering testing at home considerably decreased the cost of testing. Testand-treat strategies have also been employed in smaller trials, for specific demographic subgroups, defined by social status (e.g., incarcerated individuals) [88-91], geographical area [92][93][94], sexual behavior (e.g., MSM, sex workers) [95,96], or risk of infection (e.g., drug users) [97] with the goal to achieve local elimination, so-called micro-elimination [98,99]. Some of these trials achieved very high participation and testing rates from the eligible populations, much larger than those reported in the studies of the general population.…”

Section: Plos Onementioning

confidence: 99%

Impact of voluntary testing on infectious disease epidemiology: A game theoretic approach

Pepiot,

Supervie,

Breban

2023

PLoS ONE

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The World Health Organization recommends test-and-treat interventions to curb and even eliminate epidemics of HIV, viral hepatitis, and sexually transmitted infections (e.g., chlamydia, gonorrhea, syphilis and trichomoniasis). Epidemic models show these goals are achievable, provided the participation of individuals in test-and-treat interventions is sufficiently high. We combine epidemic models and game theoretic models to describe individual’s decisions to get tested for infectious diseases within certain epidemiological contexts, and, implicitly, their voluntary participation to test-and-treat interventions. We develop three hybrid models, to discuss interventions against HIV, HCV, and sexually transmitted infections, and the potential behavioral response from the target population. Our findings are similar across diseases. Particularly, individuals use three distinct behavioral patterns relative to testing, based on their perceived costs for testing, besides the payoff for discovering their disease status. Firstly, if the cost of testing is too high, then individuals refrain from voluntary testing and get tested only if they are symptomatic. Secondly, if the cost is moderate, some individuals will test voluntarily, starting treatment if needed. Hence, the spread of the disease declines and the disease epidemiology is mitigated. Thirdly, the most beneficial testing behavior takes place as individuals perceive a per-test payoff that surpasses a certain threshold, every time they get tested. Consequently, individuals achieve high voluntary testing rates, which may result in the elimination of the epidemic, albeit on temporary basis. Trials and studies have attained different levels of participation and testing rates. To increase testing rates, they should provide each eligible individual with a payoff, above a given threshold, each time the individual tests voluntarily.

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“…SVR is defined as undetectable HCV RNA in peripheral blood 12 weeks after the end of the treatment (41). Limiting factor, first of all in developing countries, for usement of DAA, is high cost (48).…”

Section: Diagnosis and Therapy Of Chronic Hcv Infectionmentioning

confidence: 99%

HCV Infection and Chronic Renal Disease

Sekulic

Mijailović

Petrović

et al. 2021

Serbian Journal of Experimental and Clinical Research

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Chronic Hepatitis C virus (HCV) infection is defined as persistence of HCV RNA in the blood for more than six months. HCV is a major cause of chronic liver disease and cirrhosis. It’s serious public health problem, affects about 71 million people worldwide. HCV doesn’t destroy hepatocytes directly. It activates the host's innate and acquired immune system and causes liver injury indirectly. Behind hepatic, HCV can cause extra-hepatic manifestations. One of them is renal disease which can lead to end-stage renal disease, ESRD. The prevalence of HCV infection in patients on hemodialysis is high, ranging from 5% to 60%. HCV infection is a significant cause of morbidity and mortality in patients with ESRD on hemodialysis. In this review, we discuss HCV infection and chronic renal disease as comorbidities, their severity and outcome.

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Micro-elimination of HCV as a possible therapeutic strategy: our experience and a review of literature

Cited by 4 publications

References 21 publications

Implementation of Microelimination Strategy in Eradication of Chronic Hepatitis C Infection in Patients With Hemophilia in the Northern Region of Serbia

Implementation of Microelimination Strategy in Eradication of Chronic Hepatitis C Infection in Patients With Hemophilia in the Northern Region of Serbia

Impact of voluntary testing on infectious disease epidemiology: A game theoretic approach

HCV Infection and Chronic Renal Disease

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