Hepatitis C Virus Prevalence and Risk Factors in a Village in Northeastern Romania-A Population-Based Screening-The First Step to Viral Micro-Elimination.

Laura Huiban,Anca Trifan,Camelia Cojocariu,Tudor Cuciureanu,Stefan Chiriac,Sebastian Zenovia,Vladut Mirel Burduloi,Oana Petrea,Irina Gîrleanu,Carol Stanciu,Ana Maria Sîngeap,Cristina Maria Muzica,Cătălin Sfarti

doi:10.3390/healthcare9060651

Abstract

(1) Background: The World Health Organization adopted a strategy for the Global Health Sector on Viral Hepatitis in 2016, with the main objective of eliminating hepatitis C virus (HCV) by 2030. In this work, we aimed to evaluate the prevalence of HCV infection and risk factors in a Romanian village using population-based screening as part of the global C virus eradication program. (2) Methods: We conducted a prospective study from March 2019 to February 2020, based on a strategy as part of a project designed to educate, screen, treat and eliminate HCV infection in all adults in a village located in Northeastern Romania. (3) Results: In total, 3507 subjects were invited to be screened by rapid diagnostic orientation tests (RDOT). Overall, 2945 (84%) subjects were tested, out of whom 78 (2.64%) were found to have positive HCV antibodies and were scheduled for further evaluation in a tertiary center of gastroenterology/hepatology in order to be linked to care. In total, 66 (85%) subjects presented for evaluation and 55 (83%) had detectable HCV RNA. Of these, 54 (98%) completed antiviral treatment and 53 (99%) obtained a sustained virological response. (4) Conclusions: The elimination of hepatitis C worldwide has a higher chance of success if micro-elimination strategies based on mass screening are adopted.

Highlights

Hepatitis C virus (HCV) infection represents one of the most common causes of endstage liver disease and hepatocellular carcinoma (HCC) and represents a major public health issue, with a global death rate exceeding that of HIV, tuberculosis or malaria [1]
The prevalence of positive HCV antibodies in the rural population that presented for testing was 2.64% (Figure 1)
The introduction in 2013 of direct-acting antivirals for the treatment of HCV infection and the achievement of increased rates of sustained virologic response after treatment prompted the World Health Organization to adopt the first ambitious strategy for the Global Health Sector on Viral Hepatitis in 2016, with its main objective being the elimination of HCV infection as a public health threat by 2030 [14,21]

Summary

Introduction

Hepatitis C virus (HCV) infection represents one of the most common causes of endstage liver disease and hepatocellular carcinoma (HCC) and represents a major public health issue, with a global death rate exceeding that of HIV, tuberculosis or malaria [1]. The global prevalence of viremic HCV was estimated to be 1% in 2015, corresponding to 71 million people worldwide, with 1.75 million new infections a year, which are associated with healthcare, drug use and blood transfusion before the screening of donors [2,3]. In Central and Eastern Europe, the prevalence of anti-HCV antibodies varies between 0.27 and 3.5%, with the number of people infected with HCV in the general population being about 1.16 million [4,5]. Romania is considered to be the country with the highest prevalence of HCV in Europe, with various reported figures in recent decades (5.9% in 1990, 3.23% in 2010 and recently estimated at 2.7%, corresponding to 550,000 patients with viral loads) [6,7]. An estimation of the number of people infected with HCV in the population is very important for a country’s health policy as it allows the planning of preventive and therapeutic interventions, as well as the determination of the need for the treatment of infected persons

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Discussion

Conclusion