Význam terénního testování v eliminaci hepatitidy C
| Title in English | Impact of outreach testing on elimination of hepatitis C |
|---|---|
| Authors | |
| Year of publication | 2021 |
| Type | Article in Periodical |
| Magazine / Source | Klinická mikrobiologie a infekční lékařství |
| MU Faculty or unit | |
| Citation | |
| Keywords | chronic hepatitis C; HCV; outreach testing; outreach screening; PWIDs; HCV elimination |
| Description | Objectives: Analysis of changes in patient´s population with chronic hepatitis C (CHC) treated with direct-acting antivirals (DAA) with a special focus on risk factors of transmission. Evaluation of the cooperation with organizations working with people who inject drugs (PWID) including the impact of outreach testing. Methods: Retrospective analysis and interannual comparison of the patients with CHC treated with DAA between 2018 and 2020 at the Department of Infectious Diseases, University Hospital Brno, Czech Republic. Results: A total of 291 (101 in the year 2018, 111 in 2019 and 79 in 2020) patients with CHC have been treated. Comparison of results from the year 2018, 2019 and 2020 demonstrated significant rise in PWIDs proportion (46.5 %; 64.9 % and 65.8 %). Also, the proportion of genotype 3a infection (23.8 %; 30.6 % and 35.4 %) increased at the expense of genotype 1b infection (52.5 %; 46.9 % and 38 %). Contrary, the age (median 43, 40 and 38 years) and proportion of patients with liver cirrhosis decreased (20.8 %; 15.3 % and 12.7 %). The percentage of patients starting DAA therapy within one year of diagnosis raised (47.5 %; 53.2 % and 62 %). The overall share of patients recruited due to cooperation raised (5.9 %; 25.2% and 25.3 %). The downside was the high number of patient lost to follow up (19.8 %; 23.4 % and 22.3 %). There were mostly patients which have finished the planned duration of therapy and their loss of follow-up was after the final dose of therapy. Conclusions: PWIDs becoming a dominant group of patients with CHC, which is accompanied by the decrease of mean age, the share of patients with genotype 1b, and significant liver fibrosis. Changing the spectrum of CHC patients forcing medical professionals to change their approach to diagnosis and treatment of HCV infection. Outreach testing and cooperation with support organizations showed to be an effective way to set a course to eliminate HCV in the PWIDs population. |