FROM POLICY TO PRACTICE: HEPATITIS C CARE INDICATORS IN URUGUAY BEFORE AND AFTER THE INTRODUCTION OF PUBLIC HEALTH STRATEGIES

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.102040

Victoria Mainardi , Susana Cabrera , Luciana Noble , Daniela Olivari , Solange Gerona , Sebastian Marciano , Huaiyang Zhong , Julio Medina

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引用次数: 0

Abstract

Introduction and Objectives

Uruguay has implemented measures since 2022 to strengthen its hepatitis C response, aligned with WHO’s 2030 elimination targets. These include national guidelines and awareness campaigns. In July 2024, two key policies were introduced: the inclusion of HCV RNA testing in the national health plan and a one-time anti-HCV screening during mandatory health exams for work and physical activity, initially targeting individuals aged 56–64.

We aimed to assess differences in the national hepatitis C cascade of care before and after the implementation of these public policies.

Materials and Methods

Data were collected through structured surveys sent by the Ministry of Health to all 44 national healthcare providers. Cascade indicators were analyzed for 2022, 2023 and 2024, including anti-HCV testing, seropositivity, HCV RNA testing, RNA positivity, and treatment initiation. All indicators were normalized per 100,000 users covered by respondents.

Results

In 2024, 29 healthcare providers responded (covering 90% of health system users). In 2022–2023, 22 providers reported laboratory indicators (35% coverage), while 25 reported treatment indicators (73%).

Anti-HCV testing rose from 2,883 in 2022 to 5,548 per 100,000 users in 2024. HCV RNA testing increased from 6.1 to 20.4, and treatment initiation from 2.6 to 4.9 per 100,000 users. Seropositivity remained stable (0.7%). Among anti-HCV–positive individuals, HCV RNA testing uptake increased from 37% in 2022 to 54% in 2024.

Conclusions

Improvements observed in the cascade of care align with the implementation of targeted hepatitis C policies, highlighting their potential role in supporting national elimination efforts.

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从政策到实践：乌拉圭实施公共卫生战略前后的丙型肝炎护理指标

引言和目标乌拉圭自2022年以来已实施措施，根据世卫组织2030年消除丙型肝炎的具体目标，加强丙型肝炎应对工作。这些措施包括国家指导方针和提高认识运动。2024年7月，引入了两项关键政策：将丙型肝炎病毒RNA检测纳入国家卫生计划，以及在强制性工作和身体活动健康检查期间进行一次性抗丙型肝炎病毒筛查，最初针对56-64岁的个体。我们的目的是评估在实施这些公共政策之前和之后国家丙型肝炎级联治疗的差异。材料和方法通过卫生部向所有44家国家卫生保健提供者发送的结构化调查收集数据。分析了2022年、2023年和2024年的级联指标，包括抗HCV检测、血清阳性、HCV RNA检测、RNA阳性和治疗开始。所有指标均按受访者所涵盖的每10万名用户进行标准化。结果2024年，共有29家医疗服务提供者做出回应（覆盖90%的卫生系统用户）。2022-2023年，22家医疗服务提供者报告了实验室指标（覆盖率35%），25家报告了治疗指标（73%）。Anti-HCV检测从2022年的2883例上升到2024年的每10万用户5548例。HCV RNA检测从6.1增加到20.4，治疗起始从每10万用户2.6增加到4.9。血清阳性保持稳定（0.7%）。在抗HCV阳性个体中，HCV RNA检测的使用率从2022年的37%上升到2024年的54%。结论：在护理级联中观察到的改善与有针对性的丙型肝炎政策的实施相一致，突出了其在支持国家消除工作中的潜在作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.