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. 2021 Jan 19;16(1):5.
doi: 10.1186/s13027-021-00345-8.

Hepatitis C virus cascade of care in the general population, in people with diabetes, and in substance use disorder patients

Olivera Djuric  1   2 , Marco Massari  3 , Marta Ottone  4 , Giorgia Collini  4 , Pamela Mancuso  4 , Massimo Vicentini  4 , Antonio Nicolaci  5 , Angela Zannini  5 , Alessandro Zerbini  6 , Valeria Manicardi  7 , Loreta A Kondili  8 , Paolo Giorgi Rossi  4
Affiliations

Hepatitis C virus cascade of care in the general population, in people with diabetes, and in substance use disorder patients

Olivera Djuric et al. Infect Agent Cancer. .

Abstract

Background: The aim was to evaluate the hepatitis C virus (HCV) cascade of care in the general population (GP) and in two high-risk populations: patients with diabetes mellitus (DM) and substance users (AS) in treatment in Reggio Emilia Province, Italy.

Methods: A population-based cross-sectional study was conducted that included 534,476 residents of the Reggio Emilia Province, of whom 32,800 were DM patients and 2726 AS patients. Age-adjusted prevalence was calculated using the direct method of adjustment based on the age-specific structure of EU population.

Results: The prevalence of HCV testing was 11.5%, 13.8%, and 47.8% in GP, DM, and AS patients respectively, while HCV prevalence was 6.5/1000, 12.6/1000, and 167/1000, respectively. The prevalence of HCV RNA positivity was 4.4/1000, 8.7/1000, and 114/1000 in the three populations, respectively. The rates of HCV RNA-positive individuals not linked to care were 27.9%, 27.3%, and 26% in GP, DM, and AS patients, respectively, while the rates of those cured or cleared were 70.9%, 71%, and 69.9%, respectively. The prevalence of HCV testing was higher for females of reproductive age than for males the same age: 218.4/1000 vs. 74.0/1000, respectively. While more foreigners than Italians underwent the HCV test and were HCV positive, fewer foreigners than Italians received HCV treatment and were cured.

Conclusions: The low HCV testing and linkage to care rates remain an important gap in the HCV cascade of care in Northern Italy. The prevalence of cured/cleared residents remains lower among foreigners than among Italians.

Keywords: Addiction; Cascade of care; Diabetes mellitus; Hepatitis C virus; Hepatocellular carcinoma; Linkage to care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
HCV cascade of care in the general population tested for HCV from 1/7/2008 to 31/12/2017. *inconclusive result, haemolysed serum, blank tubes, reversed sample, sample not received, test not performed. **Treatment data available for the period 2015–2019
Fig. 2
Fig. 2
HCV cascade of care in the diabetic population tested for HCV from 1/7/2008 to 31/12/2017. *inconclusive result, haemolysed serum, blank tubes, reversed sample, sample not received, test not performed. **Treatment data available for the period 2015–2019
Fig. 3
Fig. 3
HCV cascade of care in the AS population tested for HCV from 1/7/2008 to 31/12/2017. *inconclusive result, haemolysed serum, blank tubes, reversed sample, sample not received, test not performed. **Treatment data available for the period 2015–2019
Fig. 4
Fig. 4
Prevalence of HCV tested and HCV-positive individuals by age and sex
Fig. 5
Fig. 5
Prevalence of HCV tested and HCV-positive individuals by age and citizenship
See this image and copyright information in PMC

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