Cargando…

Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions

Background: Free-of-charge HCV screening in some key populations and in 1969–1989 birth cohorts has been funded in Italy as the first step to diagnosing individuals who are infected but asymptomatic. The aim of this study is to evaluate the feasibility of an opportunistic HCV screening and its linka...

Descripción completa

Detalles Bibliográficos
Autores principales: Rosato, Valerio, Kondili, Loreta A., Nevola, Riccardo, Perillo, Pasquale, Mastrocinque, Davide, Aghemo, Alessio, Claar, Ernesto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143022/
https://www.ncbi.nlm.nih.gov/pubmed/35632837
http://dx.doi.org/10.3390/v14051096
_version_ 1784715703030382592
author Rosato, Valerio
Kondili, Loreta A.
Nevola, Riccardo
Perillo, Pasquale
Mastrocinque, Davide
Aghemo, Alessio
Claar, Ernesto
author_facet Rosato, Valerio
Kondili, Loreta A.
Nevola, Riccardo
Perillo, Pasquale
Mastrocinque, Davide
Aghemo, Alessio
Claar, Ernesto
author_sort Rosato, Valerio
collection PubMed
description Background: Free-of-charge HCV screening in some key populations and in 1969–1989 birth cohorts has been funded in Italy as the first step to diagnosing individuals who are infected but asymptomatic. The aim of this study is to evaluate the feasibility of an opportunistic HCV screening and its linkage to care. Methods: A hospital-based HCV screening was conducted as a routine test for in-patients admitted to the Evangelical Hospital Betania of Naples from January 2020 to May 2021. All consecutive in-patients were screened for the HCV antibody (HCV-Ab) at the time of their admission to the hospital, and those born prior to year 2000 were included in the study. HCV-RNA testing was required for those not previously treated and without antiviral treatment contraindications. For in-patients with an active infection, treatment started soon after hospital admission. Results: Among 12,665 inpatients consecutively screened, 510 (4%) were HCV-Ab positive. The HCV-Ab positivity rate increased with age, reaching the highest prevalence (9.49%) in those born before 1947. Among patients positive for HCV, 118 (23.1%) had been previously treated, 172 (33.9%) had been discharged before being tested for HCV-RNA, and 26 (5.1%) had not been tested for short life expectancy. Of 194 (38% of HCV-Ab+) patients who were tested for HCV-RNA, 91 (46.2%) were HCV-RNA positive. Of patients with active infection, 33 (36%) were admitted to the liver unit with signs of liver damage either not previously diagnosed or diagnosed but unlinked to care for HCV infection. Of the patients positive for HCV-RNA, 87 (95.6%) started treatment; all achieved sustained virological response. Conclusion: HCV active infection has been frequently found in patients with comorbidities admitted in the hospital in Southern Italy. To achieve HCV elimination in Italy, broader screening strategies are required. In addition to screening of the 1969–1989 birth cohort of individuals unaware of their infection status, diagnosis and linkage to care of patients with known liver damage is strictly required. Hospital screening is feasible, but prompt reflex testing for identifying HCV-active infections is necessary to increase diagnosis and subsequent linkage to care.
format Online
Article
Text
id pubmed-9143022
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-91430222022-05-29 Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions Rosato, Valerio Kondili, Loreta A. Nevola, Riccardo Perillo, Pasquale Mastrocinque, Davide Aghemo, Alessio Claar, Ernesto Viruses Article Background: Free-of-charge HCV screening in some key populations and in 1969–1989 birth cohorts has been funded in Italy as the first step to diagnosing individuals who are infected but asymptomatic. The aim of this study is to evaluate the feasibility of an opportunistic HCV screening and its linkage to care. Methods: A hospital-based HCV screening was conducted as a routine test for in-patients admitted to the Evangelical Hospital Betania of Naples from January 2020 to May 2021. All consecutive in-patients were screened for the HCV antibody (HCV-Ab) at the time of their admission to the hospital, and those born prior to year 2000 were included in the study. HCV-RNA testing was required for those not previously treated and without antiviral treatment contraindications. For in-patients with an active infection, treatment started soon after hospital admission. Results: Among 12,665 inpatients consecutively screened, 510 (4%) were HCV-Ab positive. The HCV-Ab positivity rate increased with age, reaching the highest prevalence (9.49%) in those born before 1947. Among patients positive for HCV, 118 (23.1%) had been previously treated, 172 (33.9%) had been discharged before being tested for HCV-RNA, and 26 (5.1%) had not been tested for short life expectancy. Of 194 (38% of HCV-Ab+) patients who were tested for HCV-RNA, 91 (46.2%) were HCV-RNA positive. Of patients with active infection, 33 (36%) were admitted to the liver unit with signs of liver damage either not previously diagnosed or diagnosed but unlinked to care for HCV infection. Of the patients positive for HCV-RNA, 87 (95.6%) started treatment; all achieved sustained virological response. Conclusion: HCV active infection has been frequently found in patients with comorbidities admitted in the hospital in Southern Italy. To achieve HCV elimination in Italy, broader screening strategies are required. In addition to screening of the 1969–1989 birth cohort of individuals unaware of their infection status, diagnosis and linkage to care of patients with known liver damage is strictly required. Hospital screening is feasible, but prompt reflex testing for identifying HCV-active infections is necessary to increase diagnosis and subsequent linkage to care. MDPI 2022-05-19 /pmc/articles/PMC9143022/ /pubmed/35632837 http://dx.doi.org/10.3390/v14051096 Text en © 2022 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
Rosato, Valerio
Kondili, Loreta A.
Nevola, Riccardo
Perillo, Pasquale
Mastrocinque, Davide
Aghemo, Alessio
Claar, Ernesto
Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions
title Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions
title_full Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions
title_fullStr Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions
title_full_unstemmed Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions
title_short Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions
title_sort elimination of hepatitis c in southern italy: a model of hcv screening and linkage to care among hospitalized patients at different hospital divisions
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9143022/
https://www.ncbi.nlm.nih.gov/pubmed/35632837
http://dx.doi.org/10.3390/v14051096
work_keys_str_mv AT rosatovalerio eliminationofhepatitiscinsouthernitalyamodelofhcvscreeningandlinkagetocareamonghospitalizedpatientsatdifferenthospitaldivisions
AT kondililoretaa eliminationofhepatitiscinsouthernitalyamodelofhcvscreeningandlinkagetocareamonghospitalizedpatientsatdifferenthospitaldivisions
AT nevolariccardo eliminationofhepatitiscinsouthernitalyamodelofhcvscreeningandlinkagetocareamonghospitalizedpatientsatdifferenthospitaldivisions
AT perillopasquale eliminationofhepatitiscinsouthernitalyamodelofhcvscreeningandlinkagetocareamonghospitalizedpatientsatdifferenthospitaldivisions
AT mastrocinquedavide eliminationofhepatitiscinsouthernitalyamodelofhcvscreeningandlinkagetocareamonghospitalizedpatientsatdifferenthospitaldivisions
AT aghemoalessio eliminationofhepatitiscinsouthernitalyamodelofhcvscreeningandlinkagetocareamonghospitalizedpatientsatdifferenthospitaldivisions
AT claarernesto eliminationofhepatitiscinsouthernitalyamodelofhcvscreeningandlinkagetocareamonghospitalizedpatientsatdifferenthospitaldivisions