Semin Liver Dis 2022; 42(02): 159-172
DOI: 10.1055/a-1777-6112
Review Article

A Global Systematic Review of Hepatitis C Elimination Efforts through Micro-Elimination

1   Barcelona Institute for Global Health (ISGlobal), Hospital Clínic de Barcelona, Spain
2   Faculty of Medicine, University of Barcelona, Barcelona, Spain
,
Camila A. Picchio
1   Barcelona Institute for Global Health (ISGlobal), Hospital Clínic de Barcelona, Spain
,
Christopher J. Byrne
3   Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, United Kingdom
,
Javier Crespo
4   Department of Gastroenterology and Hepatology, University Hospital Marques de Valdecilla. Research Institute Valdecilla-IDIVAL, Santander, Spain
,
Massimo Colombo
5   General Medicine & Liver Center, San Raffaele Hospital, Milan, Italy
,
Graham S. Cooke
6   Division of Infectious Diseases, Faculty of Medicine, Imperial College London, United Kingdom
,
Gregory J. Dore
7   The Kirby Institute, UNSW Sydney, Australia
,
Jason Grebely
7   The Kirby Institute, UNSW Sydney, Australia
,
John W. Ward
8   Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Atlanta, United States
,
John F. Dillon
3   Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, United Kingdom
9   Department of Gastroenterology, Ninewells Hospital & Medical School, Dundee, United Kingdom
› Author Affiliations


Abstract

Microelimination targets specific subpopulations and/or geographic settings for hepatitis C virus (HCV) elimination. This review reports on global HCV microelimination literature published from 2013 to 2020. Data were extracted from publications to report a score based on the four key components defining microelimination. Sustained virologic response (SVR) and treatment initiation proportions were calculated for each manuscript and grouped means of these estimates were compared depending on microelimination score and care setting. A total of 83% of the studies were from high-income settings and mainly included people who use drugs or those incarcerated. Among manuscripts, 18 had “low” microelimination scores, 11 had “high” scores, and the differences in mean proportion who initiated treatment and achieved SVR between low and high score groups were statistically significant. Microelimination can be a useful complementary strategy for driving engagement in HCV treatment and cure. Our analysis suggests that adhering to more of the core microelimination components can improve outcomes. This study is registered with Prospero, registration identification: CRD42020175211.

Authors' Contributions

J.V.L. conceived of the article and developed the preliminary outline. C.A.P. and C.B. performed the literature and conference abstract review with supervision and input from J.V.L. and J.F.D. Each author (J.C., M.C., G.C., G.J.D., J.G., and J.W.W.) reviewed a subset of data extracted from included articles for verification and doubts were resolved by J.V.L. through consensus with C.A.P., C.B., and J.F.D. C.A.P. prepared the first draft of the manuscript with input from C.B. C.B. undertook statistical analysis. All authors contributed to and reviewed the full draft of the article, subsequent revisions, and approved the final version for submission.


Financial Support

None.


Supplementary Material



Publication History

Accepted Manuscript online:
21 February 2022

Article published online:
23 June 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA