Chronic hepatitis C virus infections in Switzerland in 2020: Lower than expected and suggesting achievement of <scp>WHO</scp> elimination targets

Bertisch, Barbara; Scheffold, Christian; Schmid, Patrick; Peter, Laura; Vernazza, Pietro; Isler, Marc; Oppliger, Robert A.; Schmidt, Axel J.

doi:10.1111/jvh.13842

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Considering data available at the end of 2020, a recent analysis by Bertisch et al estimates that the prevalence of chronic hepatitis C in the general Swiss population is ≤0.1%, corresponding to 5900-9200 viraemic people [10] which is definitely lower than former estimations [7,9].…”

Section: Representativeness Ongoing Intravenous Drug Use and Hcv Ab P...mentioning

confidence: 93%

“…This number had de-clined to 32,100 at the beginning of 2020 [9]. In contrast, a study from Bertisch et al, which is also based on 2020 data but primarily uses sources with effective HCV management, estimates the number to be significantly lower [10][11][12][13]. According to the Federal Office of Public Health (FOPH) reporting system and the Swiss Hepatitis C Cohort Study (SCCS), the proportion of people who inject drugs among the Swiss HCV population is about 60% [14][15][16].…”

Section: Introductionmentioning

confidence: 96%

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Hepatitis C prevalence and cascade of care among patients in the decentralised opioid agonist therapy programme of the canton of St Gallen, Switzerland: a cross-sectional study

Wissel,

Vernazza,

Kuster

et al. 2024

Swiss Med Wkly

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BACKGROUND: To eliminate chronic hepatitis C virus (HCV) infection by 2030, 90% of those infected must be diagnosed and 80% treated. In Switzerland, >40% of the estimated 32,000 infected people are still undiagnosed. In the canton of St Gallen, HCV prevalence and cascade of care have only been studied in the centralised opioid agonist therapy (OAT) setting (institutions), although about 80% of OAT patients are treated decentrally (general practitioner [GP] or pharmacy). AIM: To describe HCV prevalence and cascade of care among patients in the decentralised OAT programme of the canton of St Gallen, Switzerland, and compare it to contemporaneous data from the centralised setting. METHODS: For each patient receiving his/her OAT from a GP or pharmacy on 1 April 2021, the cantonal medical office sent a questionnaire to the prescribing GP. Patient characteristics, HCV antibody (Ab)/RNA screening uptake, HCV Ab/RNA prevalence and HCV treatment uptake were obtained and compared to those of patients of the Medizinisch-soziale Hilfsstelle 1 in St Gallen (centralised setting). RESULTS: Of the 563 OAT patients under the care of 127 GPs, 107 patients from 41 GPs could be analysed (median age: 48 years [IQR: 40–56]; ongoing intravenous drug use: 25%; OAT provider: 66% GP, 34% pharmacy). HCV Ab screening uptake was 68% (73/107) with an HCV Ab prevalence of 68% (50/73) among those tested. Of the HCV Ab-positive patients, 84% (42/50) were HCV RNA-tested, among whom 57% (24/42) were viraemic. HCV treatment uptake was 83% (20/24), with 95% (19/20) achieving a sustained virological response. Non-uptake of HCV screening and treatment tended to be higher among patients receiving OAT at the pharmacy vs at the GP’s office: 37% vs 26% (p = 0.245) for screening and 30% vs 7% (p = 0.139) for treatment. The proportion never HCV Ab-tested and the proportion of HCV Ab-positives never HCV RNA-tested was significantly higher in the decentralised compared to the centralised setting: 32% vs 3% (p <0.001) never Ab-tested and 16% vs 0% (p = 0.002) never RNA-tested. In contrast, HCV treatment uptake (83% vs 78%), sustained virological response rate (95% vs 100%) and residual HCV RNA prevalence among the HCV Ab-positive (12% vs 14%) were comparable for both settings. CONCLUSION: In the decentralised OAT setting of the canton of St Gallen, HCV Ab prevalence is high. Since HCV Ab and RNA screening uptake are markedly lower than in the centralised setting, potentially >40% of patients with chronic HCV are not diagnosed yet. HCV screening in the decentralised setting needs improvement, e.g. by increasing awareness and simplifying testing. High HCV treatment uptake and cure rates are possible in centralised and decentralised settings.

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Section: Representativeness Ongoing Intravenous Drug Use and Hcv Ab P...mentioning

confidence: 93%

Section: Introductionmentioning

confidence: 96%

Hepatitis C prevalence and cascade of care among patients in the decentralised opioid agonist therapy programme of the canton of St Gallen, Switzerland: a cross-sectional study

Wissel,

Vernazza,

Kuster

et al. 2024

Swiss Med Wkly

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Assessing the hepatitis C epidemiology in Switzerland: It’s not that trivial

Blach

Bregenzer

Bruggmann

et al. 2023

Journal of Viral Hepatitis

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Reply to ‘Assessing the hepatitis C epidemiology in Switzerland: It’s not that trivial’

Bertisch,

Schaetti,

Schmid

et al. 2023

Journal of Viral Hepatitis

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We thank Sarah Blach et al. 1 for bringing attention to our update paper on the prevalence of HCV infections in Switzerland. 2 Blach et al. aim to challenge our estimate of 5900-9200 persons living in Switzerland with chronic hepatitis C in 2020 (0.1% viraemic prevalence). Their main argument against our new estimates is the unfounded allegation that we did not handle the large number of publications we reviewed for this update according to scientific standards (implying that this slipped the reviewers and editors as well). We will counter their criticism point by point in the following.However, we would also like to mention that, in contrast, we have received positive feedback from other scientists in the field. The Principal Expert on Hepatitis of the European Centre for Disease Prevention and Control (ECDC), Dr Erika Duffell, wrote to us, 'The Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

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Chronic hepatitis C virus infections in Switzerland in 2020: Lower than expected and suggesting achievement of WHO elimination targets

Cited by 4 publications

References 33 publications

Hepatitis C prevalence and cascade of care among patients in the decentralised opioid agonist therapy programme of the canton of St Gallen, Switzerland: a cross-sectional study

Hepatitis C prevalence and cascade of care among patients in the decentralised opioid agonist therapy programme of the canton of St Gallen, Switzerland: a cross-sectional study

Assessing the hepatitis C epidemiology in Switzerland: It’s not that trivial

Reply to ‘Assessing the hepatitis C epidemiology in Switzerland: It’s not that trivial’

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