ELIMINATE: a PCR record-based macroelimination project for systematic recall of HCV-RNA-positive persons in Austria.

IF 1.9 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Wiener Klinische Wochenschrift Pub Date : 2024-05-01 Epub Date: 2023-09-29 DOI:10.1007/s00508-023-02275-4

Caroline Schwarz, David Bauer, Livia Dorn, Mathias Jachs, Lukas Hartl, David Chromy, Lukas Weseslindtner, Nikolaus Pfisterer, Barbara Hennlich, Annika Stückler, Robert Strassl, Astrid Voill-Glaninger, Wolfgang Hübl, Martin Willheim, Karin Köhrer, Sonja Jansen-Skoupy, Sabine Tomez, Walter Krugluger, Christian Madl, Michael Schwarz, Lorenz Balcar, Georg Semmler, Leonard Brinkmann, Lukas Burghart, Lukas Antonitsch, Gerhard Weidinger, Florian Riedl, Hermann Laferl, Vesselina Kurteva, Marianna Traugott, Julian Hind, Christoph Wenisch, Abdelrahman Aburaia, Christian Sebesta, Daniela Schmid, Sonja Rothweiler, Jelena Remetic, Michael Gschwantler, Andreas Maieron, Thomas Reiberger

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引用次数: 0

Abstract

Background and aims: Micro-elimination projects targeted to specific hepatitis C virus (HCV) risk populations have been successful. Systematic identification of persons with HCV viremia, regardless of risk group, based on already available laboratory records may represent an effective macroelimination approach to achieve global HCV elimination.

Methods: Persons with a last positive HCV-RNA PCR result between 2008-2020 in the reference virology laboratories in eastern Austria were identified. First, (i) we described their demographic characteristics, (ii) we systematically recalled persons to the respective centers and (iii) started antiviral treatment if HCV-RNA viremia was confirmed, and (iv) recorded sustained virologic response (SVR). This interim report includes the preliminary results from 8 participating centers.

Results: During the study period 22,682 persons underwent HCV-RNA PCR testing, 11,216 (49.4%) were positive at any point in time, and 6006 (26.5%) showed detectable HCV-RNA at the last PCR test, suggesting ongoing HCV viremia. At the time of this interim report, 2546/6006 HCV-RNA PCR(+) persons were evaluated: 443/2546 (17.4%) had died, 852/2546 (33.5%) had invalid contact data, and 547/2546 (21.5%) had achieved SVR between data retrieval and recall. Contact could be established in 236/704 (33.5%) of the remaining target population with 97/236 (41.1%) presenting at the clinic for treatment evaluation. Ultimately, 71/236 (30.1%) started antiviral treatment and SVR was documented in 47/71 (66.2%).

Conclusion: This ELIMINATE project based on systematic assessment of HCV-RNA PCR-records, identified 6006 persons with potential persisting HCV viremia. Invalid contact data and missed visits for treatment evaluation were the main barriers towards HCV elimination within this project. Importantly, many subjects with HCV viremia lost to follow-up were successfully linked to care and started antiviral treatment.

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消除：一个基于PCR记录的大规模消除项目，用于奥地利HCV RNA阳性者的系统召回。

背景和目的：针对特定丙型肝炎病毒（HCV）风险人群的微量消除项目取得了成功。根据现有的实验室记录，系统地识别丙型肝炎病毒血症患者，无论其风险组如何，可能是实现全球丙型肝炎病毒消除的一种有效的大规模消除方法。方法：对2008-2020年期间奥地利东部参考病毒学实验室最后一次HCV-RNA PCR结果呈阳性的人进行鉴定。首先，（i）我们描述了他们的人口统计学特征，（ii）我们系统地将人员召回各自的中心，（iii）如果确认了HCV-RNA病毒血症，则开始抗病毒治疗，以及（iv）记录了持续的病毒学反应（SVR）。本中期报告包括8个参与中心的初步结果。结果：在研究期间，22682人接受了HCV-RNA PCR检测，11216人（49.4%）在任何时间点呈阳性，6006人（26.5%）在最后一次PCR检测中显示可检测到HCV-RNA，表明正在进行HCV病毒血症。在本中期报告发布时，对2546/6006名HCV-RNA PCR（+）人员进行了评估：443/2546人（17.4%）死亡，852/2566人（33.5%）的接触数据无效，547/2546人在数据检索和召回之间实现了SVR。其余目标人群中有236/704人（33.5%）可以建立联系，97/236人（41.1%）在诊所接受治疗评估。最终，71/236（30.1%）开始抗病毒治疗，47/71（66.2%）记录了SVR。结论：该消除项目基于对HCV-RNA PCR记录的系统评估，确定了6006名潜在的持续性HCV病毒血症患者。无效的接触者数据和错过治疗评估是该项目中消除丙型肝炎病毒的主要障碍。重要的是，许多失去随访的HCV病毒血症受试者成功地与护理联系起来，并开始抗病毒治疗。

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

Wiener Klinische Wochenschrift 医学-医学：内科

CiteScore

4.70

自引率

3.80%

发文量

110

审稿时长

4-8 weeks

期刊介绍： The Wiener klinische Wochenschrift - The Central European Journal of Medicine - is an international scientific medical journal covering the entire spectrum of clinical medicine and related areas such as ethics in medicine, public health and the history of medicine. In addition to original articles, the Journal features editorials and leading articles on newly emerging topics, review articles, case reports and a broad range of special articles. Experimental material will be considered for publication if it is directly relevant to clinical medicine. The number of international contributions has been steadily increasing. Consequently, the international reputation of the journal has grown in the past several years. Founded in 1888, the Wiener klinische Wochenschrift - The Central European Journal of Medicine - is certainly one of the most prestigious medical journals in the world and takes pride in having been the first publisher of landmarks in medicine.