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DOI: 10.1055/s-0039-1691904
HCV-Scenario over the last decade at the Medical University Vienna: 6023 viremic HCV(+) patients identified with an 'overestimated' number of 3499 patients potentially left to cure
Publication History
Publication Date:
16 May 2019 (online)
Background and Aims:
The World Health Organization aims to eliminate hepatitis C virus (HCV) infection until 2030. The setup of a national HCV elimination plan requires solid epidemiological data. Thus, we assessed the overall numbers of individuals who underwent testing for (i) anti-HCV, (ii) HCV-RNA-PCR and who (iii) remained HCV-viremic at last contact at the Medical University of Vienna.
Methods:
All individuals who underwent anti-HCV testing or a quantitative/qualitative HCV-RNA assessment using PCR (HCV-PCR) between 01-Jan-2008 and 31-Dec-2018 at the Medical University of Vienna were assessed.
Results:
Overall, 239.514 patients were tested for HCV (236.954/98.9% by anti-HCV ± HCV-PCR, 2.560/1.1% by HCV-PCR only). 8.331 (3.5%) patients were anti-HCV(+), including 303 with seroconversions during the observational period. While 857 patients (10.3%) were not further tested by HCV-PCR, 5.211/7.474 (69.7%) were (at some timepoint) tested positive for HCV-RNA. Including patients with HCV-PCR testing only, 10.034 individuals underwent HCV-PCR assessment of which 6.023 (60%) were at least once HCV-RNA viremic. Importantly, 3.499 (34%) remained HCV-PCR positive at their last assessment. This number corresponds to a current seroprevalence of 1.5% (3.499/239.514) viremic HCV individuals. The median time from last positive HCV-PCR to the end of the observation period was 71.4 months (interquartile-range 63.6). HCV-genotype (GT) was available in 48.8% (1.706/3.499) and GT-1a, GT-1b and GT-3 were the most prevalent with 30.3% (518/1.706), 25.2% (431/1.706) and 21.0% (359/1.706), respectively.
Conclusions:
Among almost 10.000 anti-HCV(+) and/or HCV-RNA(+) patients at the Medical University of Vienna, 3.499 viremic patients at last HCV-PCR-testing were identified. However, this analysis currently lacks data from the national death-registry, patient tourism/migration, and testing/treatment at other centers. Thus, the 'true' number of potential HCV viremic patients is lower than 3.499. Still, this calls for action in order to keep up with the 2030 HCV elimination plan and reasons for suboptimal linkage-to-care remain to be determined.