Abstract
Background: In response to the goal of the World Health Organisation to eliminate hepatitis C virus infections by 2030, Romania is striving for national elimination. An already successful micro-elimination project was expanded to test-and-treat specific populations and at-risk groups. The aim of this project was to identify the individuals with HCV infection in disadvantaged regions who do not have proper medical care access. Materials and Methods: Our two-arm interventional cross-sectional study used rapid anti-HCV antibody testing on two population groups from the Romanian southwestern region of Oltenia, approached between September 2020 and May 2021. The first group consisted of predominantly over 40 years old individuals, recruited through five family doctors from two medium-sized towns (community lot—CL). We approached a second group, aged 18–65, through 11 medical offices of five large factories in the same region (industry lot, IL). A 12-items questionnaire was given to each participant, to determine risk factors and record demographic data. Eligible patients initiated antiviral therapy using direct-acting antivirals (DAAs). Results: We enrolled 15,383 individuals between all 16 locations. The overall prevalence by antibody testing was 0.77% (119 cases). Of these, 57 subsequently received treatment with DAAs. We identified blood transfusions as a risk factor within the CL. Participants in the IL reported a relatively high risk for the following situations: sharing of personal hygiene belongings with another person, performing previous blood transfusions, dental interventions and previous surgery. Conclusions: In this global context, the use of micro-elimination allows interventions to be faster and more efficient. This is possible by targeting smaller and specific HCV risk groups.
Highlights
Introduction distributed under the terms andDiscovered in 1989, hepatitis C virus (HCV) is a single-stranded enveloped RNA virus that replicates in the hepatocytes [1]
Infection can be responsible for liver disease with progressive scarring of the liver and hepatocellular carcinoma (HCC) if screening is not followed by treatment [3]
We identified a relatively significant risk regarding blood transfusions ysis for each of the possible etiological factors which resulted from completing the ques(Fisher test p < 0.0005; relative risk–RR 3.039 (95% confidence range–95% confidence intervals (95%CI) 1.787–4.843))
Summary
Introduction distributed under the terms andDiscovered in 1989, hepatitis C virus (HCV) is a single-stranded enveloped RNA virus that replicates in the hepatocytes [1]. Hepatitis C viral infections can be classified as acute and chronic. The management of patients with chronic HCV infection has progressed the most in the current biomedical era by introducing the novel drugs in 2013 which target the replication cycle, called direct-acting antivirals (DAAs) [4]. An already successful microelimination project was expanded to test-and-treat specific populations and at-risk groups. The aim of this project was to identify the individuals with HCV infection in disadvantaged regions who do not have proper medical care access. Materials and Methods: Our two-arm interventional cross-sectional study used rapid anti-HCV antibody testing on two population groups from the Romanian southwestern region of Oltenia, approached between September 2020 and May 2021.
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