Opportunistic co‐screening for <scp>HCV</scp> and <scp>COVID</scp>‐19‐related services: A creative response with a need for thoughtful reflection

Kondili, Loreta A.; Craxì, Lucia; Andreoni, Massimo; Mennini, Francesco Saverio; Razavi, Homie

doi:10.1111/liv.15243

Cited by 7 publications

(6 citation statements)

References 19 publications

(95 reference statements)

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“…HCV-active screening of people born between 1969 and 1989; people who inject drugs (PWID), followed by addiction services; and inmates, independently of their age, has been funded by the Italian National Health System as the first key step to achieving the HCV-elimination in Italy [ 10 ]. Addressing first previous or active PWID, prisoners, as well as other at-risk populations (migrants, sex workers, and people having undergone risky nosocomial or esthetic procedures) [ 5 , 6 , 10 , 22 , 23 , 24 ] will give the possibility to identify HCV infected people in a sexually active age, often completely asymptomatic and without perception of the infectious risk and reduce the infection burden, limiting the infection spread and the progression to further disease stages [ 25 ]. Opportunistic screening for the younger population, is a rapid and efficient way to and cure HCV infection; however, this should not be the only way to reach younger populations, because people belonging to these populations are less likely to have hospital admission…”

Section: Discussionmentioning

confidence: 99%

Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions

Rosato¹,

Kondili

Nevola³

et al. 2022

Viruses

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Background: Free-of-charge HCV screening in some key populations and in 1969–1989 birth cohorts has been funded in Italy as the first step to diagnosing individuals who are infected but asymptomatic. The aim of this study is to evaluate the feasibility of an opportunistic HCV screening and its linkage to care. Methods: A hospital-based HCV screening was conducted as a routine test for in-patients admitted to the Evangelical Hospital Betania of Naples from January 2020 to May 2021. All consecutive in-patients were screened for the HCV antibody (HCV-Ab) at the time of their admission to the hospital, and those born prior to year 2000 were included in the study. HCV-RNA testing was required for those not previously treated and without antiviral treatment contraindications. For in-patients with an active infection, treatment started soon after hospital admission. Results: Among 12,665 inpatients consecutively screened, 510 (4%) were HCV-Ab positive. The HCV-Ab positivity rate increased with age, reaching the highest prevalence (9.49%) in those born before 1947. Among patients positive for HCV, 118 (23.1%) had been previously treated, 172 (33.9%) had been discharged before being tested for HCV-RNA, and 26 (5.1%) had not been tested for short life expectancy. Of 194 (38% of HCV-Ab+) patients who were tested for HCV-RNA, 91 (46.2%) were HCV-RNA positive. Of patients with active infection, 33 (36%) were admitted to the liver unit with signs of liver damage either not previously diagnosed or diagnosed but unlinked to care for HCV infection. Of the patients positive for HCV-RNA, 87 (95.6%) started treatment; all achieved sustained virological response. Conclusion: HCV active infection has been frequently found in patients with comorbidities admitted in the hospital in Southern Italy. To achieve HCV elimination in Italy, broader screening strategies are required. In addition to screening of the 1969–1989 birth cohort of individuals unaware of their infection status, diagnosis and linkage to care of patients with known liver damage is strictly required. Hospital screening is feasible, but prompt reflex testing for identifying HCV-active infections is necessary to increase diagnosis and subsequent linkage to care.

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Section: Discussionmentioning

confidence: 99%

Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions

Rosato¹,

Kondili

Nevola³

et al. 2022

Viruses

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“…Our study suggests that the additional preventive policy measures in homelessness services in Amsterdam may have resulted in limited COVID transmission among PEH, although the effect of having less contacts and a more solitary life than the general population could not be ruled out. Therefore, as COVID-19 continues to circulate around the world, emergency services for PEH should remain in place and vaccination uptake should be evaluated, in particular because PEH are regarded to be at increased risk of severe COVID-19 due to comorbidities (7,26), including infections such as hepatitis C (27), and because we found vaccination intention among PEH to be low.…”

Section: Discussionmentioning

confidence: 99%

Low prevalence of current and past SARS-CoV-2 infections among visitors and staff members of homelessness services in Amsterdam at the end of the second wave of infections in the Netherlands

Santen

Campman

Booij

et al. 2022

Preprint

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Background People experiencing homelessness (PEH) may be at increased risk of SARS-CoV-2 infection and severe COVID-19. The Dutch government established emergency shelters and introduced preventive measures for homelessness services and there were no major SARS-CoV-2 outbreak noticed among PEH during the first two waves of infections. This study aimed to assess the prevalence of current and past infections among PEH and staff at the end of the second COVID-19 wave by conducting an on-site COVID-19 screening project at homelessness services in Amsterdam, the Netherlands. Methods We assessed the proportion of visitors and staff members of four homelessness services at two locations in Amsterdam with positive SARS-CoV-2 qPCR and antibody results (IgG/IgM Rapid Test, Biozek) in May 2021. We also assessed sociodemographic, clinical and lifestyle characteristics, compliance with basic prevention measures and intention to vaccinate against COVID-19 among PEH and staff.Results A total of 138 visitors and 53 staff members filled out a questionnaire and were tested. Among PEH, the SARS-CoV-2 positivity rate was 0% (0/133;95%CI=0-1.9) and the antibody positivity rate was 1.6% (2/131;95%CI=0.8-7.5). Among staff, these percentages were 3% (1/32;95%CI=0.1-16.2) and 11% (5/53;95%CI=3.6-23.6), respectively. Most participants were frequently compliant with the basic preventive measures ‘not shaking hands’, ‘wearing a face mask’ and ‘washing hands’, but not with ‘physical distancing’. Overall, intention to vaccinate for COVID-19 was low (30% for visitors, 10% for staff) or medium (28% for visitors, 35% for staff). Trust in COVID-19 policies were also, for the most part, low (27% for visitors, 17% for staff) or neutral (32% for visitors, 53% for staff).Conclusions We observed a low prevalence of past and current SARS-CoV-2 infections among PEH, which may be explained by instated shelter policies, limited daily activities of PEH and compliance with certain prevention measures. Vaccine hesitancy and mistrust among visitors and staff could hinder vaccination uptake, suggesting that improvements in public heath communication and interventions towards visitors and staff of homelessness services are needed.

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“…Efforts to increase COVID-19 vaccine uptake should combine vaccination with education about and detection of other diseases like HCV 43 , 44 and HIV 45 , as well as the hepatitis B virus, and linkage to care, if needed, to maximise the use of each healthcare encounter and mitigate aforementioned factors that hinder disease screening, such as a lack of knowledge and mistrust in the health system 31 , 32 . With regards HCV testing in particular, resources could be further maximised by omitting HCV Ab screening and only testing for HCV-RNA in individuals with a known history of HCV, as those with a previous infection will continue to test HCV Ab+ 2 , which was evident in this study´s results.…”

Section: Discussionmentioning

confidence: 99%

Combined COVID-19 vaccination and hepatitis C virus screening intervention in marginalised populations in Spain

et al. 2023

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Background COVID-19 has hindered hepatitis C virus (HCV) and HIV screening, particularly in marginalised groups, who have some of the highest rates of these conditions and lowest rates of COVID-19 vaccination. We assessed the acceptability of combining HCV testing with COVID-19 vaccination in a centre for addiction services (CAS) in Barcelona and a mobile testing unit (MTU) in Madrid, Spain. Methods From 28/09/2021 to 30/06/2022, 187 adults from marginalised populations were offered HCV antibody (Ab) testing along with COVID-19 vaccination. If HCV Ab+, they were tested for HCV-RNA. MTU participants were also screened for HIV. HCV-RNA+ and HIV+ participants were offered treatment. Data were analysed descriptively. Results Findings show how of the 86 CAS participants: 80 (93%) had been previously vaccinated for COVID-19, of whom 72 (90%) had the full first round schedule; none had a COVID-19 vaccine booster and all received a COVID-19 vaccine; 54 (62.8%) were tested for HCV Ab, of whom 17 (31.5%) were positive, of whom all were tested for HCV-RNA and none were positive. Of the 101 MTU participants: none had been vaccinated for COVID-19 and all received a COVID-19 vaccine; all were tested for HCV Ab and HIV and 15 (14.9%) and 9 (8.9%) were positive, respectively; of those HCV Ab+, 9 (60%) were HCV-RNA+, of whom 8 (88.9%) have started treatment; 5 (55.6%) of those HIV+ had abandoned antiretroviral therapy, of whom 3 (60%) have re-started it. Conclusions The intervention was accepted by 54 (62.8%) CAS participants and all MTU participants and can be used in marginalised communities.

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Opportunistic co‐screening for HCV and COVID‐19‐related services: A creative response with a need for thoughtful reflection

Cited by 7 publications

References 19 publications

Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions

Elimination of Hepatitis C in Southern Italy: A Model of HCV Screening and Linkage to Care among Hospitalized Patients at Different Hospital Divisions

Low prevalence of current and past SARS-CoV-2 infections among visitors and staff members of homelessness services in Amsterdam at the end of the second wave of infections in the Netherlands

Combined COVID-19 vaccination and hepatitis C virus screening intervention in marginalised populations in Spain

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