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

D Chromy; R Schmidt; F Mayer; D Bauer; B Simbrunner; C Schmidbauer; M Gschwantler; P Ferenci; M Trauner; M Mandorfer; T Reiberger

doi:10.1055/s-0039-1691904

Zeitschrift für Gastroenterologie, Table of Contents

Z Gastroenterol 2019; 57(05): e150
DOI: 10.1055/s-0039-1691904

POSTER

Hepatologie

Georg Thieme Verlag KG Stuttgart · New York

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

Authors

D Chromy

¹Department of Dermatology, Medical University of Vienna, Vienna, Austria

²Vienna HIV & Liver Study Group, Vienna, Austria

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
R Schmidt

⁴Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
F Mayer

⁴Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
D Bauer

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

²Vienna HIV & Liver Study Group, Vienna, Austria
B Simbrunner

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

²Vienna HIV & Liver Study Group, Vienna, Austria
C Schmidbauer

⁵Department of Internal Medicine IV, Wilhelminenspital, Wiener Krankenanstaltenverbund (KAV) der Stadt Wien, Vienna, Austria

²Vienna HIV & Liver Study Group, Vienna, Austria

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
M Gschwantler

⁵Department of Internal Medicine IV, Wilhelminenspital, Wiener Krankenanstaltenverbund (KAV) der Stadt Wien, Vienna, Austria
P Ferenci

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
M Trauner

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
M Mandorfer

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

²Vienna HIV & Liver Study Group, Vienna, Austria
T Reiberger

³Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

²Vienna HIV & Liver Study Group, Vienna, Austria

Abstract

Full Text

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.