scholarly journals Identification and treatment of viral hepatitis C in persons who use drugs: a prospective, multicenter outreach study in Flanders, Belgium

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Dana Busschots ◽  
Cécile Kremer ◽  
Rob Bielen ◽  
Özgür Muhammet Koc ◽  
Leen Heyens ◽  
...  

Abstract Background Targeted screening for hepatitis C viral (HCV) infection is not yet widely executed in Belgium. When performed in people who use drugs (PWUD), it is mainly focused on those receiving opiate agonist therapy (OAT). We wanted to reach out to a population of difficult to reach PWUD not on centralized OAT, using non-invasive screening as a bridge to re-integration in medical care supported by facilitated referral to a specialist. Methods This was a prospective, multicenter cohort study in PWUD not enrolled in a centralized OAT program in a community-based facility in Limburg or OAT program in a community-based facility in Antwerp, Belgium, from October 2018 until October 2019. Two study teams recruited participants using an outreach method at 18 different locations. Participants were tested for HCV antibodies (Ab) by finger prick, and risk factors were assessed through a face-to-face questionnaire. Univariate analyses were used to assess the association between HCV Ab and each risk factor separately. A generalized linear mixed model was used to investigate the association between the different risk factors and HCV. Results In total, 425 PWUD were reached with a mean age of 41.6 ± 10.8, and 78.8% (335/425) were men. HCV Ab prevalence was 14.8% (63/425). Fifty-six (88.9%) PWUD were referred, of whom 37 (66.1%) were linked to care and tested for HCV RNA. Twenty-nine (78.4%) had a chronic HCV infection. Treatment was initiated in 17 (58.6%) patients. The adjusted odds for HCV Ab were highest in those with unstable housing 6 months before inclusion (p < .001, AOR 8.2 CI 95% 3.2–23.3) and in those who had ever shared paraphernalia for intravenous drug use (p < .001, AOR 6.2 CI 95% 2.5–16.0). Conclusions An important part tested positive for HCV. Treatment could be started in more than half of the chronically infected referred and tested positive for HCV-RNA. Micro-elimination is necessary to achieve the World Health Organization goals by 2030. However, it remains crucial to screen and link a broader group of PWUD to care than to focus solely on those who inject drugs. Trial registration: clinicaltrials.gov NCT04363411, Registered 27 April 2020—Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04363411?term=NCT04363411&draw=2&rank=1

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 651
Author(s):  
Laura Huiban ◽  
Carol Stanciu ◽  
Cristina Maria Muzica ◽  
Tudor Cuciureanu ◽  
Stefan Chiriac ◽  
...  

(1) Background: The World Health Organization adopted a strategy for the Global Health Sector on Viral Hepatitis in 2016, with the main objective of eliminating hepatitis C virus (HCV) by 2030. In this work, we aimed to evaluate the prevalence of HCV infection and risk factors in a Romanian village using population-based screening as part of the global C virus eradication program. (2) Methods: We conducted a prospective study from March 2019 to February 2020, based on a strategy as part of a project designed to educate, screen, treat and eliminate HCV infection in all adults in a village located in Northeastern Romania. (3) Results: In total, 3507 subjects were invited to be screened by rapid diagnostic orientation tests (RDOT). Overall, 2945 (84%) subjects were tested, out of whom 78 (2.64%) were found to have positive HCV antibodies and were scheduled for further evaluation in a tertiary center of gastroenterology/hepatology in order to be linked to care. In total, 66 (85%) subjects presented for evaluation and 55 (83%) had detectable HCV RNA. Of these, 54 (98%) completed antiviral treatment and 53 (99%) obtained a sustained virological response. (4) Conclusions: The elimination of hepatitis C worldwide has a higher chance of success if micro-elimination strategies based on mass screening are adopted.


2018 ◽  
Vol 9 (06) ◽  
pp. 20251-20256
Author(s):  
Mudassir Khan ◽  
Shahrukh Khan ◽  
Shohra Haider ◽  
Fazal Jalil ◽  
Muhsin Jamal ◽  
...  

Background: Prevalence of Hepatitis C viral infection and its major risk factors has been found out in population of Batkhela, Khyber Pakhtunkhwa, Pakistan by taking number of volunteers from the interested area. HCV prevalence has not been researched in recent time here in this area, so that’s why we contributed. Materials and Methods: Ab rapid test cassette serum/plasma (USA) kit has been used for the mentioned purpose following by ELISA and finally PCR to find out active infection of virus. ICT positive individuals were reconfirmed by ELISA and then ELISA positive samples were carefully investigated by RT-PCR for Hepatitis C Virus. Results: The study population was of 770 volunteers belonging to the mentioned area of research, 453 males and 317 females. The overall prevalence was found to be 5.32% of HCV in Batkhela. This prevalence ratio was 3.12% in males and 2.20 % in females. 3rd generation ELISA was used to refine ICT positive samples which showed that 37 of the ICT positive samples had antibodies detected by ELISA. To find out active HCV infection, ELISA positive samples were refined by real time PCR which showed 2.98% of prevalence of active HCV infection in Batkhela based on HCV RNA in their blood. Principle Conclusion: Overall prevalence was found 5.32%, contaminated reused syringes and blades at Barbour’s shop, blood transfusion, surgical operations and unhygienic food in stalls etc were found significant risk factors for acquiring HCV infection. Body weakness and pale yellow skin color was common symptom in HCV positive volunteers. Safe sexual activities, blood screening before donation and sterilizing surgical equipment’s can protect us from Hepatitis C Virus.


Author(s):  
Dominique L Braun ◽  
Benjamin Hampel ◽  
Bruno Ledergerber ◽  
Christina Grube ◽  
Huyen Nguyen ◽  
...  

Abstract Background In 2016, the World Health Organization (WHO) introduced global targets for the elimination of hepatitis C virus (HCV) by 2030. We conducted a nationwide HCV micro-elimination program among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) from the Swiss HIV Cohort Study (SHCS) to test whether the WHO goals are achievable in this population. Methods During phase A (10/2015–06/2016), we performed a population-based and systematic screening for HCV-RNA among MSM from the SHCS. During phase B (06/2016–02/2017) we offered treatment with HCV direct-acting antiviral (DAA) agents to MSM identified with a replicating HCV infection. During phase C (03/2017–11/2017), we offered rescreening to all MSM for HCV-RNA and initiated DAA treatment in MSM with replicating infections. Results We screened 3715/4640 (80%) MSM and identified 177 with replicating HCV infections (4.8%); 150 (85%) of whom started DAA treatment and 149 (99.3%) were cured. We rescreened 2930/3538 (83%) MSM with a prior negative HCV-RNA and identified 13 (0.4%) with a new HCV infection. At the end of the micro-elimination program, 176/190 MSM (93%) were cured, and the HCV incidence rate declined from .53 per 100 patient-years (95% CI, .35–.83) prior to the intervention to .12 (95% CI, .03–.49) by the end of 2019. Conclusions A systematic, population-based HCV micro-elimination program among MSM living with HIV was feasible and resulted in a strong decline in HCV incidence and prevalence. Our study can serve as a model for other countries aiming to achieve the WHO HCV elimination targets. Clinical Trials Registration NCT02785666.


2015 ◽  
Vol 77 (25) ◽  
Author(s):  
Waqar Al-Kubaisy ◽  
Nor Aini Mohd Noor ◽  
Nik Shamsidah Nik Ibrahim ◽  
Usama Al-Nasirie

Hepatitis C virus (HCV) infection is an important global public health problem affecting approximately 180 million people. Multiple risk factors are associated with HCV transmission among haemodialysis (HD) patients leading to an increased risk for liver-related mortality. Patients undergoing HD may show a decreased humoral and cellular immunity, which lowers the sensitivity of the HCV antibodies (Abs) test resulting in false negative antibody test, thus requiring HCV RNA testing. Our study is to determine the prevalence of HCV markers (antibody RNA and genotype) and risk factors of HCV infection among patients in HD unit in Baghdad. A sample of 54 patients were interviewed. HCV Abs (anti-HCV) was tested using third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia-Tek III) as screening and confirmatory test respectively. Sera of 46 patients (irrespective to anti-HCV results) were subjected to molecular analysis, using the most developed RT-PCR and DNA Enzyme immunoassay (DEIA) method. Seropositive rate of anti-HCV and HCV-RNA were (66.6%) and (60.9%) respectively. Anti-HCV seropositive rate was significantly higher in males (77.1%), and history of blood transfusion (85%). Blood transfusion acts as a significant risk for acquiring HCV (OR 44.2, 95% CI 7.6-256.9). Genotype 4 was the most prevalent (33.3%), followed by genotype 1a (25.9%) and genotype 1b (22.2%). We concluded that, the prevalence of HCV among the haemodialysis patients is high. It is significantly related to gender, duration of dialysis and number of blood transfusion. Blood transfusion acts as a significant risk factor. Molecular test for detection for HCV RNA is necessary and proper nosocomial prevention program should be implemented to prevent HCV transmission.


Author(s):  
Romulo Celli ◽  
Saad Saffo ◽  
Saleem Kamili ◽  
Nicholas Wiese ◽  
Tonya Hayden ◽  
...  

Context.— Treatment of chronic viral hepatitis C (HCV) infection with direct-acting antiviral agents (DAAs) results in cure, or sustained viral response (SVR), in more than 90% of patients. However, there are subsets of patients who have persistent liver inflammation and fibrosis and develop hepatocellular carcinoma (HCC) despite achieving SVR. A possible reason for these phenomena may be the presence of virus particles in liver tissue but not blood, otherwise defined as occult infection. Objective.— To describe liver histologic findings following successful DAA therapy, test HCV RNA by (liver) tissue polymerase chain reaction in treated cases, and identify predictive markers for HCC development in treated cases. Design.— A total of 96 identified patients were divided into 4 groups, each differentiated by the presence or absence of SVR and HCC. Groups were compared for several clinicopathologic variables, including degree of inflammation and fibrosis, and the ‘directionality' of fibrosis in cirrhotic livers using the novel progressive-indeterminate-regressive scoring system. Results.— Overall, we found a significant decrease in inflammation in SVR patients. None of the patients showed regression of their cirrhosis following treatment. No evidence of occult HCV infection was seen in 40 livers tested, including 21 with HCC. The number of patients who developed HCC was similar in the SVR and non-SVR groups, and increased inflammation and fibrosis were associated with HCC development. Conclusions.— Following DAA-SVR there appears to be an overall decrease in inflammation, but the fibrosis tends to persist, at least in the short term (median follow-up of 20.2 months).


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
J. I. O'Reilly ◽  
P. Ocama ◽  
C. K. Opio ◽  
A. Alfred ◽  
E. Paintsil ◽  
...  

The emergence of hepatitis C virus (HCV) and its associated sequelae in Africa is a cause for significant concern. Human immunodeficiency virus (HIV) positive patients are at an increased risk of contracting HCV infection due to similar risk factors and modes of transmission. We investigated the seroprevalence of hepatitis C in hospitalized HIV-positive and HIV-negative patients in Mulago Hospital, an academic hospital in Uganda. Blood samples were first tested for HCV antibodies, and positive tests were confirmed with HCV RNA PCR. We enrolled five hundred patients, half HIV-positive and half HIV negative. Overall, 13/500 patients (2.6%) tested positive for HCV antibodies. There was no difference in HCV antibody detection among HIV-positive and HIV-negative patients. Out of all risk factors examined, only an age greater than 50 years was associated with HCV infection. Traditional risk factors for concurrent HIV and HCV transmission, such as intravenous drug use, were exceedingly rare in Uganda. Only 3 of 13 patients with detectable HCV antibodies were confirmed by HCV RNA detection. This result concurs with recent studies noting poor performance of HCV antibody testing when using African sera. These tests should be validated in the local population before implementation.


Gut ◽  
1999 ◽  
Vol 44 (6) ◽  
pp. 874-880 ◽  
Author(s):  
S Bellentani ◽  
G Pozzato ◽  
G Saccoccio ◽  
M Crovatto ◽  
L S Crocè ◽  
...  

BACKGROUNDThe severity, clinical course, and risk of hepatitis C virus (HCV) related chronic liver disease are still rather poorly defined.AIMSTo investigate the prevalence, risk factors, and severity of HCV related liver disease in the general population, and investigate whether infection with a specific genotype is associated with an increased risk of cirrhosis or hepatocellular carcinoma.METHODSHCV RNA determination by polymerase chain reaction (PCR) and HCV genotyping were performed in all anti-HCV positive subjects belonging to the Dionysos study (6917 subjects). Diagnosis of cirrhosis and hepatocellular carcinoma was established by liver biopsy in all cases. All the data were analysed by univariate and multivariate statistics in all the cohort. To investigate the natural history of HCV infection, anti-HCV positive subjects were followed up every six months for three years with liver function tests and ultrasonograms.RESULTSThe overall prevalence of HCV RNA positivity was 2.3%. Positivity increased progressively with age, and was higher in women (ratio of men to women = 0.7). Genotypes 1b and 2a were the most frequent (42 and 24% of HCV RNA positive patients), with a prevalence of 1 and 0.6% respectively. Intravenous drug use, blood transfusions received before 1990, history of previous hepatitis among the cohabiting, and history of animal (mainly dogs) bites were significantly (p<0.05) associated with HCV infection, independently of age and sex. Multivariate analysis showed that, independently of age, sex, and alcohol intake, genotype 1b infection, with or without coinfection with other genotypes, is the major risk factor associated with the presence of cirrhosis and/or hepatocellular carcinoma. During the three years of follow up, 57 (35%) of the HCV RNA positive subjects had consistently normal alanine aminotransferase and γ-glutamyltransferase values. Two of the 22 HCV RNA positive cirrhotic patients, all drinking more than 90 g of alcohol a day, developed hepatocellular carcinoma (incidence rate = 3.0% per year).CONCLUSIONSIn the general population of Northern Italy, HCV infection is widespread, but only less than 50% of the anti-HCV positive subjects, particularly those infected with genotype 1b, are associated with a more severe liver disease. Alcohol consumption greater that 30 g a day significantly aggravates the natural course of the disease.


Author(s):  
Mohamed Rida Tagajdid ◽  
Safae Elkochri ◽  
Hicham Elannaz ◽  
Rachid Abi ◽  
Idriss Lahlou Amine

Objectives: In Morocco, the exact and recent prevalence of Hepatitis C Virus (HCV) infection is not well-known, due to the lack of recent epidemiological studies of the general Moroccan population. The objective of this study was to determine the prevalence of HCV and to describe the epidemiological, clinical and virological characteristics of patients infected with HCV diagnosed at the Mohammed V Military Teaching Hospital in Rabat, Morocco. Methods: This was a prospective study, spread over a period of 3 years (April 2015 - April 2018). All patients with a positive anti-HCV serology were included in the study except those on hemodialysis. In addition to HCV serology, all patients included benefited from HIV serology as well as the Hbs antigen by a Chemiluminescent type Microparticle Immuno-Assay technique (Architect®, Abbott). RNA viral load and HCV genotyping was carried out using a real-time polymerase chain reaction. Results: We collected 14,944 samples, of which 269 had positive anti-HCV antibodies (1.8%). The average age of patients with positive HCV serology was 61 years, the sex ratio (Male/Female) was 1.4. Dental care was identified in 53% of the cases. Viral hepatitis C was identified in 82% of cases during a systematic check up. The main clinical signs reported in our series were asthenia (25% of cases) and subicterus (7% of cases). Conclusion and Implications for Translation: In Morocco, the exact prevalence of HCV infection is not well known, due to the lack of recent epidemiological studies of the general Moroccan population. Our study showed a prevalence of about 1.8% which is in accordance with the World Health Organization (WHO) estimation of between 1% and 2.49%.Our Epidemiological study provides important on the extent of the problem in Morocco, it raises the interest of mass screening and describes the populations at risk that will need to be identified as a priority. Key words: • Epidemiology • Diagnosis • Hepatitis C • Morocco • Risk factor • Military Hospital • Virology   Copyright © 2020 Tagajdid et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2014 ◽  
Vol 142 (12) ◽  
pp. 2616-2623 ◽  
Author(s):  
D. SIMON ◽  
R. T. MICHITA ◽  
J. U. BÉRIA ◽  
D. C. TIETZMANN ◽  
A. T. STEIN ◽  
...  

SUMMARYWe studied hepatitis C virus (HCV) prevalence and risk factors for HCV infection in a sample of Brazilian HIV-positive patients. A cross-sectional study was conducted with 580 HIV-positive patients from a specialized HIV/AIDS diagnosis and treatment centre in southern Brazil. All patients were interviewed for socio-demographic and risk factors and tested for HCV antibodies and HCV-RNA detection. A multivariate analysis was performed to identify risk factors for HCV infection. A total of 138 (24%) patients had past or chronic hepatitis C. The following risk factors were associated with HCV infection for each gender: alcohol misuse and injecting drug use in women (P < 0·001) and low educational level, smoking drug use, and injecting drug use in men (P < 0·01). These results suggest that alcohol misuse, low educational level, smoking drug use, and injecting drug use are probable risk factors for HCV infection in HIV-positive patients. This information contributes to an understanding of the epidemiology of HIV/HCV co-infection in Brazil.


Author(s):  
Ranti Permatasari ◽  
Aryati Aryati ◽  
Budi Arifah

Hepatitis C (HCV) infection could be spread by blood transfusion. Screening of HCV in donor blood could prevent HCV infection to the recipient. HCV antibody test using rapid test of multiple antibody detection by immunochromatography method is an easy and rapid test that could detect four HCV antibodies separately. The aim of this study was to evaluate the diagnostic value of antibody HCV using multiple antibody detection rapid test in diagnosing HCV infection. This was an analytical observational study with a cross sectional design. The samples consisted of 42 donors’ blood serum from the Surabaya Branch of the Indonesian Red Cross which underwent HCV infection test using ELISA method. The samples were then tested using PCR HCV RNA as the gold standard and antibody HCV multiple antibodydetection rapid test The diagnostic value of HCV antibody test using multiple antibody detection rapid test by immunochromatography method showed a diagnostic sensitivity of 100%, diagnostic specificity of 75%, positive predictive value of 66.7% and negative predictive value of 100%, a diagnostic efficiency of 83.3%, with a positive probability ratio of 4 times. The most often positive antibody pattern was four (4) positive antibodies (core protein, NS3, NS4 and NS5). Core protein (CP) and NS3 were the most often positive antibodies. Based on this study result, the HCV antibody test using multiple antibody detection rapid test by immunochromatography method has a good diagnostic value.


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