Cargando…
High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85
Background and Aims: The WHO has solicited all countries to eliminate HCV by 2030. The Italian government started routine screening for HCV infection in January 2021, initially targeting subjects born between 1969 and 1989. With the aim of achieving micro-elimination, we designed a hospital-wide pro...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227146/ https://www.ncbi.nlm.nih.gov/pubmed/34205096 http://dx.doi.org/10.3390/pathogens10060695 |
_version_ | 1783712455997784064 |
---|---|
author | Piazzolla, Annarita Valeria Paroni, Giulia Bazzocchi, Francesca Cassese, Mauro Cisternino, Antonio Ciuffreda, Luigi Gorgoglione, Franco Gorgoglione, Leonardo Palazzo, Vincenzo Sciannamè, Natale Taurchini, Marco Vaira, Pasquale Cocomazzi, Giovanna Squillante, Maria Maddalena Aucella, Filippo Cascavilla, Nicola De Cosmo, Salvatore Fania, Michelantonio Greco, Antonio Laborante, Antonio Leone, Maurizio Maiello, Evaristo Salvatori, Mauro Di Mauro, Lazzaro Mangia, Alessandra |
author_facet | Piazzolla, Annarita Valeria Paroni, Giulia Bazzocchi, Francesca Cassese, Mauro Cisternino, Antonio Ciuffreda, Luigi Gorgoglione, Franco Gorgoglione, Leonardo Palazzo, Vincenzo Sciannamè, Natale Taurchini, Marco Vaira, Pasquale Cocomazzi, Giovanna Squillante, Maria Maddalena Aucella, Filippo Cascavilla, Nicola De Cosmo, Salvatore Fania, Michelantonio Greco, Antonio Laborante, Antonio Leone, Maurizio Maiello, Evaristo Salvatori, Mauro Di Mauro, Lazzaro Mangia, Alessandra |
author_sort | Piazzolla, Annarita Valeria |
collection | PubMed |
description | Background and Aims: The WHO has solicited all countries to eliminate HCV by 2030. The Italian government started routine screening for HCV infection in January 2021, initially targeting subjects born between 1969 and 1989. With the aim of achieving micro-elimination, we designed a hospital-wide project focusing on inpatients born from 1935 to 1985 and conducted it in our institution. Method: All inpatients aged 35 to 85, admitted from 10 February 2020 to 9 February 2021 for many different diseases and conditions underwent HCV antibody (HCVAb) testing by third-generation ELISA. When positive, reflex HCV RNA testing and genotyping were performed. Clinical history, fibrosis diagnosis, laboratory data and concomitant medications were available for all. Results: The HCV screening rate of inpatients was 100%. In total, 11,748 participants were enrolled, of whom 53.50% were male. The HCVAb positivity rate was 3.03%. The HCVAb rate increased with age and was higher for patients born between 1935 and 1944 (4.81%). The rate of HCV RNA positivity was 0.97%. The vast majority (80.70%) of HCV RNA-positive participants were 55 or older; in about 40% of cases, HCV RNA-positive patients were unaware of their infection. Although 16 patients died after HCV chronic infection diagnosis (two due COVID-19) or HCV treatment prescription (one due to COVID-19), 74.56% of patient HCV diagnoses were linked to HCV treatment, despite their co-morbidities. All patients older than 65 who died had an active HCV infection. Conclusion: The present study revealed a rate of active HCV infections among inpatients lower than what has been reported in the past in the general population; this appears to be a result of the widespread use of pangenotypic direct-acting antiviral agents (DAAs). The overall rate of active infection was lower than the rate observed in the 1935–1954 cohort. The high rate of inpatients unaware of HCV infections and the high number of deaths among subjects with an active HCV infection born from 1935 to 1954, suggest that, at least in southern Italy, targeted screening of this birth cohort may be required to reduce the number of undiagnosed cases and hidden infections. |
format | Online Article Text |
id | pubmed-8227146 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-82271462021-06-26 High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85 Piazzolla, Annarita Valeria Paroni, Giulia Bazzocchi, Francesca Cassese, Mauro Cisternino, Antonio Ciuffreda, Luigi Gorgoglione, Franco Gorgoglione, Leonardo Palazzo, Vincenzo Sciannamè, Natale Taurchini, Marco Vaira, Pasquale Cocomazzi, Giovanna Squillante, Maria Maddalena Aucella, Filippo Cascavilla, Nicola De Cosmo, Salvatore Fania, Michelantonio Greco, Antonio Laborante, Antonio Leone, Maurizio Maiello, Evaristo Salvatori, Mauro Di Mauro, Lazzaro Mangia, Alessandra Pathogens Article Background and Aims: The WHO has solicited all countries to eliminate HCV by 2030. The Italian government started routine screening for HCV infection in January 2021, initially targeting subjects born between 1969 and 1989. With the aim of achieving micro-elimination, we designed a hospital-wide project focusing on inpatients born from 1935 to 1985 and conducted it in our institution. Method: All inpatients aged 35 to 85, admitted from 10 February 2020 to 9 February 2021 for many different diseases and conditions underwent HCV antibody (HCVAb) testing by third-generation ELISA. When positive, reflex HCV RNA testing and genotyping were performed. Clinical history, fibrosis diagnosis, laboratory data and concomitant medications were available for all. Results: The HCV screening rate of inpatients was 100%. In total, 11,748 participants were enrolled, of whom 53.50% were male. The HCVAb positivity rate was 3.03%. The HCVAb rate increased with age and was higher for patients born between 1935 and 1944 (4.81%). The rate of HCV RNA positivity was 0.97%. The vast majority (80.70%) of HCV RNA-positive participants were 55 or older; in about 40% of cases, HCV RNA-positive patients were unaware of their infection. Although 16 patients died after HCV chronic infection diagnosis (two due COVID-19) or HCV treatment prescription (one due to COVID-19), 74.56% of patient HCV diagnoses were linked to HCV treatment, despite their co-morbidities. All patients older than 65 who died had an active HCV infection. Conclusion: The present study revealed a rate of active HCV infections among inpatients lower than what has been reported in the past in the general population; this appears to be a result of the widespread use of pangenotypic direct-acting antiviral agents (DAAs). The overall rate of active infection was lower than the rate observed in the 1935–1954 cohort. The high rate of inpatients unaware of HCV infections and the high number of deaths among subjects with an active HCV infection born from 1935 to 1954, suggest that, at least in southern Italy, targeted screening of this birth cohort may be required to reduce the number of undiagnosed cases and hidden infections. MDPI 2021-06-03 /pmc/articles/PMC8227146/ /pubmed/34205096 http://dx.doi.org/10.3390/pathogens10060695 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Piazzolla, Annarita Valeria Paroni, Giulia Bazzocchi, Francesca Cassese, Mauro Cisternino, Antonio Ciuffreda, Luigi Gorgoglione, Franco Gorgoglione, Leonardo Palazzo, Vincenzo Sciannamè, Natale Taurchini, Marco Vaira, Pasquale Cocomazzi, Giovanna Squillante, Maria Maddalena Aucella, Filippo Cascavilla, Nicola De Cosmo, Salvatore Fania, Michelantonio Greco, Antonio Laborante, Antonio Leone, Maurizio Maiello, Evaristo Salvatori, Mauro Di Mauro, Lazzaro Mangia, Alessandra High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85 |
title | High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85 |
title_full | High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85 |
title_fullStr | High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85 |
title_full_unstemmed | High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85 |
title_short | High Rates of Hidden HCV Infections among Hospitalized Patients Aged 55–85 |
title_sort | high rates of hidden hcv infections among hospitalized patients aged 55–85 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227146/ https://www.ncbi.nlm.nih.gov/pubmed/34205096 http://dx.doi.org/10.3390/pathogens10060695 |
work_keys_str_mv | AT piazzollaannaritavaleria highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT paronigiulia highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT bazzocchifrancesca highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT cassesemauro highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT cisterninoantonio highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT ciuffredaluigi highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT gorgoglionefranco highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT gorgoglioneleonardo highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT palazzovincenzo highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT sciannamenatale highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT taurchinimarco highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT vairapasquale highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT cocomazzigiovanna highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT squillantemariamaddalena highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT aucellafilippo highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT cascavillanicola highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT decosmosalvatore highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT faniamichelantonio highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT grecoantonio highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT laboranteantonio highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT leonemaurizio highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT maielloevaristo highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT salvatorimauro highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT dimaurolazzaro highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 AT mangiaalessandra highratesofhiddenhcvinfectionsamonghospitalizedpatientsaged5585 |