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Multicenter Study
. 2023 Dec;43(12):2645-2656.
doi: 10.1111/liv.15727. Epub 2023 Sep 16.

A territory-wide opportunistic, hospital-based HCV screening in the general population from northern Italy: The 1969-1989 birth-cohort

Collaborators, Affiliations
Free article
Multicenter Study

A territory-wide opportunistic, hospital-based HCV screening in the general population from northern Italy: The 1969-1989 birth-cohort

Roberta D'Ambrosio et al. Liver Int. 2023 Dec.
Free article

Abstract

Background and aim: The World Health Organization (WHO) goal of Hepatitis C Virus (HCV) elimination by 2030 rose awareness about the need of screening plans, worldwide. In Italy, graduated screening starting from people born in 1969-1989 might be the most-effective strategy. We performed an opportunistic HCV screening study in the general population attending health facilities in Lombardy region, Northern Italy.

Methods: This is a prospective, multicenter, territory-wide, opportunistic study supported by the Regional Government of Lombardy, Italy. Between June 2022 and December 2022, all subjects born in 1969-1989, hospitalized or accessing blood collection centres were offered anti-HCV and HCV-RNA tests. Patients with known anti-HCV positivity and/or previous anti-HCV treatment were excluded. Demographic features were uploaded into a regional web-based platform.

Results: In total, 120 193 individuals were screened in 75 centres. Mean age was 44 (±6) years, 65.2% were females, 83.7% were tested at blood collection centres. Anti-HCV tested positive in 604 (0.50%) subjects: mean age 47 (±5), 51.1% females. HCV seroprevalence was higher in males (p < 0.00001), elderly (p < 0.00001) and in- vs. outpatients (p = 0.0009). HCV-RNA was detectable in 125 out of 441 (28.3%) anti-HCV positive subjects. Actively infected patients were 46 (±6) years old, mainly males (56.8%). The overall prevalence of active HCV infection was 0.10%, higher in elderly (p = 0.0003) and in in-patients (p = 0.0007). Among 93 HCV-RNA positive patients, the median age was 48 years, 58% males, 62% Italian born, median HCV-RNA levels were 6,1 log IU/mL, liver stiffness measurement (LSM) values 5.5 (3.1-29.9) kPa and ALT levels 48 U/L.

Conclusions: The prevalence of active HCV infection in the 1969-1989 population attending health facilities in Lombardy was low. Most viremic patients were Italian-born, with mild liver disease but high-HCV-RNA levels. Due to the higher prevalence in the elderly, the extension of such opportunistic screening programs to lower birth cohorts would be warranted.

Keywords: 1969-1989; WHO; birth cohorts; hepatitis C virus; screening.

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References

REFERENCES

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    1. Accessed September 6, 2022. https://www.who.int/publications/i/item/9789241565455
    1. Kondili LA, Andreoni M, Alberti A, et al. Estimated prevalence of undiagnosed HCV infected individuals in Italy: a mathematical model by route of transmission and fibrosis progression. Epidemics. 2021;34:100442.
    1. Kondili L, Blach S, Razavi H, Craxì A. Tailored screening and dedicated funding for direct acting antiviral drugs: how to keep Italy on the road to hepatitis C elimination? Ann Ist Super Sanità. 2020;56:325-329.

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