Hepatitis C screening, diagnosis, and cascade of care among people aged > 40 years in Brasilia, Brazil

Abstract

Background: Identifying patients with hepatitis C virus (HCV) infection and enhancing the cascade of care are essential for eliminating HCV infection. This study aimed to estimate the prevalence of positive anti-HCV serology in Brasilia, Brazil, and evaluate the efficiency of the cascade of care for HCV-positive individuals.Methods: This cross-sectional study analyzed 57,697 rapid screening tests for hepatitis C in individuals aged > 40 years between June 2018 and June 2019. HCV-positive patients were contacted and scheduled to undergo the HCV RNA viral test, genotyping, and transient elastography.Results: The prevalence of positive serology was 0.27%. Among 161 patients with positive anti-HCV serology, 124 (77%) were contacted, 109 (67.7%) were tested for HCV RNA viral load, and 69 (42.8%) had positive results. Genotype 1 (75%) was the most prevalent genotype. Among 65 patients (94.2%) who underwent transient elastography, 30 (46.2%) presented with advanced fibrosis. Additionally, of the 161 patients, 55 (34.1%) were referred for treatment, but only 39 (24.2%) complied, with 36 (22.4%) showing sustained virological response. By the end of the study, 16 patients were still awaiting to receive medication. Conclusions:The prevalence of HCV-positive patients was low in Brasilia, and the gaps in the cascade of care for these patients were significantly below the targets of HCV infection elimination. This study opens new avenues for eliminating HCV infection and suggests that partnerships with clinical laboratories to conduct anti-HCV tests are a useful strategy to improve HCV diagnosis.

Subclinical Hepatitis C Virus Infection in Patients with Chronic Obstructive Pulmonary Disease: Evidence from a Cross-Sectional Multicenter Observation Study

“…Therefore, there is a need for clinical trials to evaluate the efficacy and tolerance of the direct-acting antiviral agents for the treatment of HCV-associated renal diseases. In the present study, we found a comparatively low prevalence of HCV in COPD patients compared to previous studies worldwide (25,26). The reports on the association between HCV infection and COPD are exiguous.…”

Liver injury predicts overall mortality in severe COVID-19: a prospective multicenter study in Brazil

“…Viral hepatitis serologies, history of alcohol intake or co-medications use prior to hospital admission were not available. However, the prevalence rates of chronic hepatitis B and C are low in Brazil [ 22 , 23 ] and only four patients (1%) included in the present study reported any liver disease at admission. In addition, we considered aminotransferases levels collected at the first day of hospitalization to minimize the impact of long term COVID-19 or any hepatic drug induced toxicity during hospital stay.…”

Avaliação Do Conhecimento Sobre a Hepatite C Por Pacientes Em Atendimento Nos Ambulatórios Do Cemed-Uniderp

“…Atualmente, no Brasil, o tratamento da hepatite C crônica é realizado pelo Sistema Único de Saúde (SUS), com medicamentos antivirais com alta efetividade terapêutica e que possuem como objetivos: erradicar a carga viral; atrasar a progressão da fibrose; aliviar os sintomas; prevenir complicações, com o intuito de diminuir a mortalidade, além de melhorar a qualidade de vida dos pacientes (CHHATWAL et al, 2016). O maior desafio é encontrar os pacientes que são soropositivos para o vírus da hepatite C para realizar o tratamento, antes que evoluam para formas complicadas da doença hepática (CARVALHO-LOURO et al, 2020).…”

“…O que se observa, portanto, é que para que seja alcançado o objetivo de erradicação da hepatite C, até 2030, faz-se necessário um maior investimento em políticas públicas de saúde em campanhas informativas e de testagem rápida para a população, tendo a inclusão de testes para HCV no risco cirúrgico e, também, para familiares de pessoas soropositivas como estratégias que auxiliariam no objetivo de minimizar o tempo de evolução da patologia (CARVALHO-LOURO et al, 2020).…”