TY - JOUR
T1 - Eliminate
T2 - a PCR record-based macroelimination project for systematic recall of HCV-RNA-positive persons in Austria
AU - Schwarz, Caroline
AU - Bauer, David
AU - Dorn, Livia
AU - Jachs, Mathias
AU - Hartl, Lukas
AU - Chromy, David
AU - Weseslindtner, Lukas
AU - Pfisterer, Nikolaus
AU - Hennlich, Barbara
AU - Stückler, Annika
AU - Strassl, Robert
AU - Voill-Glaninger, Astrid
AU - Hübl, Wolfgang
AU - Willheim, Martin
AU - Köhrer, Karin
AU - Jansen-Skoupy, Sonja
AU - Tomez, Sabine
AU - Krugluger, Walter
AU - Madl, Christian
AU - Schwarz, Michael
AU - Balcar, Lorenz
AU - Semmler, Georg
AU - Brinkmann, Leonard
AU - Burghart, Lukas
AU - Antonitsch, Lukas
AU - Weidinger, Gerhard
AU - Riedl, Florian
AU - Laferl, Hermann
AU - Kurteva, Vesselina
AU - Traugott, Marianna
AU - Hind, Julian
AU - Wenisch, Christoph
AU - Aburaia, Abdelrahman
AU - Sebesta, Christian
AU - Schmid, Daniela
AU - Rothweiler, Sonja
AU - Remetic, Jelena
AU - Gschwantler, Michael
AU - Maieron, Andreas
AU - Reiberger, Thomas
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/5
Y1 - 2024/5
N2 - BACKGROUND AND AIMS: Micro-elimination projects targeted to specific hepatitis C virus (HCV) risk populations have been successful. Systematic identification of persons with HCV viremia, regardless of risk group, based on already available laboratory records may represent an effective macroelimination approach to achieve global HCV elimination.METHODS: Persons with a last positive HCV-RNA PCR result between 2008-2020 in the reference virology laboratories in eastern Austria were identified. First, (i) we described their demographic characteristics, (ii) we systematically recalled persons to the respective centers and (iii) started antiviral treatment if HCV-RNA viremia was confirmed, and (iv) recorded sustained virologic response (SVR). This interim report includes the preliminary results from 8 participating centers.RESULTS: During the study period 22,682 persons underwent HCV-RNA PCR testing, 11,216 (49.4%) were positive at any point in time, and 6006 (26.5%) showed detectable HCV-RNA at the last PCR test, suggesting ongoing HCV viremia. At the time of this interim report, 2546/6006 HCV-RNA PCR(+) persons were evaluated: 443/2546 (17.4%) had died, 852/2546 (33.5%) had invalid contact data, and 547/2546 (21.5%) had achieved SVR between data retrieval and recall. Contact could be established in 236/704 (33.5%) of the remaining target population with 97/236 (41.1%) presenting at the clinic for treatment evaluation. Ultimately, 71/236 (30.1%) started antiviral treatment and SVR was documented in 47/71 (66.2%).CONCLUSION: This ELIMINATE project based on systematic assessment of HCV-RNA PCR-records, identified 6006 persons with potential persisting HCV viremia. Invalid contact data and missed visits for treatment evaluation were the main barriers towards HCV elimination within this project. Importantly, many subjects with HCV viremia lost to follow-up were successfully linked to care and started antiviral treatment.
AB - BACKGROUND AND AIMS: Micro-elimination projects targeted to specific hepatitis C virus (HCV) risk populations have been successful. Systematic identification of persons with HCV viremia, regardless of risk group, based on already available laboratory records may represent an effective macroelimination approach to achieve global HCV elimination.METHODS: Persons with a last positive HCV-RNA PCR result between 2008-2020 in the reference virology laboratories in eastern Austria were identified. First, (i) we described their demographic characteristics, (ii) we systematically recalled persons to the respective centers and (iii) started antiviral treatment if HCV-RNA viremia was confirmed, and (iv) recorded sustained virologic response (SVR). This interim report includes the preliminary results from 8 participating centers.RESULTS: During the study period 22,682 persons underwent HCV-RNA PCR testing, 11,216 (49.4%) were positive at any point in time, and 6006 (26.5%) showed detectable HCV-RNA at the last PCR test, suggesting ongoing HCV viremia. At the time of this interim report, 2546/6006 HCV-RNA PCR(+) persons were evaluated: 443/2546 (17.4%) had died, 852/2546 (33.5%) had invalid contact data, and 547/2546 (21.5%) had achieved SVR between data retrieval and recall. Contact could be established in 236/704 (33.5%) of the remaining target population with 97/236 (41.1%) presenting at the clinic for treatment evaluation. Ultimately, 71/236 (30.1%) started antiviral treatment and SVR was documented in 47/71 (66.2%).CONCLUSION: This ELIMINATE project based on systematic assessment of HCV-RNA PCR-records, identified 6006 persons with potential persisting HCV viremia. Invalid contact data and missed visits for treatment evaluation were the main barriers towards HCV elimination within this project. Importantly, many subjects with HCV viremia lost to follow-up were successfully linked to care and started antiviral treatment.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Antiviral Agents/therapeutic use
KW - Austria/epidemiology
KW - Disease Eradication
KW - Female
KW - Hepacivirus/genetics
KW - Hepatitis C/drug therapy
KW - Humans
KW - Male
KW - Middle Aged
KW - Polymerase Chain Reaction
KW - RNA, Viral/blood
KW - Sustained Virologic Response
KW - Viremia/epidemiology
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85172891029&partnerID=8YFLogxK
U2 - 10.1007/s00508-023-02275-4
DO - 10.1007/s00508-023-02275-4
M3 - Journal article
C2 - 37773541
SN - 1613-7671
VL - 136
SP - 278
EP - 288
JO - Wiener Klinische Wochenschrift. The Central European Journal of Medicine
JF - Wiener Klinische Wochenschrift. The Central European Journal of Medicine
IS - 9-10
ER -