Eliminate: a PCR record-based macroelimination project for systematic recall of HCV-RNA-positive persons in Austria

Caroline Schwarz, David Bauer, Livia Dorn, Mathias Jachs, Lukas Hartl, David Chromy, Lukas Weseslindtner, Nikolaus Pfisterer, Barbara Hennlich, Annika Stückler, Robert Strassl, Astrid Voill-Glaninger, Wolfgang Hübl, Martin Willheim, Karin Köhrer, Sonja Jansen-Skoupy, Sabine Tomez, Walter Krugluger, Christian Madl, Michael SchwarzLorenz Balcar, Georg Semmler, Leonard Brinkmann, Lukas Burghart, Lukas Antonitsch, Gerhard Weidinger, Florian Riedl, Hermann Laferl, Vesselina Kurteva, Marianna Traugott, Julian Hind, Christoph Wenisch, Abdelrahman Aburaia, Christian Sebesta, Daniela Schmid, Sonja Rothweiler, Jelena Remetic, Michael Gschwantler, Andreas Maieron, Thomas Reiberger

Research output: Journal article (peer-reviewed)Journal article

Abstract

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.

Original languageEnglish
Pages (from-to)278-288
Number of pages11
JournalWiener Klinische Wochenschrift. The Central European Journal of Medicine
Volume136
Issue number9-10
Early online date29 Sept 2023
DOIs
Publication statusE-pub ahead of print - 29 Sept 2023

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