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

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.

Keywords: cascade of care; health policy; hepatitis C virus treatment; micro-elimination; screening.

Figure 1

Screened participants for HCV infection, with number of people invited for screening, the total number of screened people and the prevalence of patients with positive HCV antibodies. HCV, hepatitis C virus.

Figure 2

The prevalence of HCV infection in different age groups.

Figure 3

Cascade of care composed of different steps. Positive HCV Ab: Number of people estimated to have viremic HCV infection. Linked to care: Number of patients evaluated for treatment. Detectable HCV-RNA: Number of patients who received a diagnosis of viremic HCV infection. This number excludes patients who were cured of their infection or who had experienced the spontaneous clearance of their infection before 2019. Treated: Number of patients who initiated HCV treatment (all types of treatment, interferon-based regimens). Cured: Number of patients who obtained a sustained virologic response (SVR).