Yee Tak Hui1, Grace L H Wong2, James Y Y Fung3, Henry L Y Chan2, Nancy W Y Leung2, Sienna D Liu2, Ken Liu2, Yiu Keung Ma4, David Y K But3, Wing Yan Mak2, Jacky M C Chan5, Kin Bon Lai6, Ching Kong Loo7, Annie C Y Ng8, Moon Sing Lai9, Chun Wing Chan10, Joulen Y L Lau11, Tina T T Fan12, Aric J Hui13, Belsy C Y Lam14, Wing I Cheung15, Owen T Y Tsang5, Karen Lam5, Lawrence S W Lai14, Wai Fan Luk5, Michael K K Li4, Wai Cheung Lao11, Jodis T W Lam1, Steven W C Tsang12, Kam Ngai Kung6, Wai Hung Chow10, Ronald K N Tong8, Thomas K L Lui3, Edwin H S Shan8, Man Fung Yuen3, Vincent W S Wong2. 1. Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China. 2. Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China. 3. Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China. 4. Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China. 5. Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China. 6. Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China. 7. Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China. 8. Department of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong, China. 9. Department of Medicine, North District Hospital, Hong Kong, China. 10. Department of Medicine, Yan Chai Hospital, Hong Kong, China. 11. Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. 12. Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China. 13. Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China. 14. Department of Medicine and Geriatrics, Pok Oi Hospital, Hong Kong, China. 15. Department of Medicine, Our Lady of Maryknoll Hospital, Hong Kong, China.
Abstract
BACKGROUND: To study the epidemiology of chronic hepatitis C virus infection in Hong Kong and to estimate the service gap for achieving the WHO hepatitis elimination targets of attaining a diagnosis rate of 90%, treatment rate of 80% and 65% reduction in mortality rate by 2030. METHODS: From January 2005 to March 2017, patients who were tested positive for anti-HCV were retrospectively retrieved from all public hospitals in Hong Kong. The epidemiological data of 15 participating hospitals were analysed. RESULTS: A total of 11 309 anti-HCV+ patients were identified and the estimated diagnosis rate was 50.9%. Our HCV-infected patients were ageing (median age 59). The all-cause mortality rate increased from 26.2 to 54.8 per 1000 person-years over the last decade. Our estimated treatment rate was 12.4%. Among the treated patients, 93.6% had received pegylated interferon/ribavirin (Peg-IFN/RBV) but only 10.8% had received interferon-free direct-acting antivirals (DAAs). In a cohort of 1533 patients, 39% already had advanced liver fibrosis or cirrhosis. The sustained virological response rate for Peg-IFN/RBV and DAAs were 74.8% and 97.2% respectively. However, more than 70% of patients were not subjected to interferon treatment for various reasons. Patients who achieved SVR were associated with a significantly lower risk of HCC (4.7% vs 9.6%, P = 0.005) and death (1.7% vs 23.8%, P < 0.001). CONCLUSION: Our diagnosis rate, treatment rate and mortality rate reduction were still low, particularly the Peg-IFN outcomes, making it difficult to meet the WHO hepatitis elimination targets. A more generalized use of DAAs is urgently needed to improve the situation.
BACKGROUND: To study the epidemiology of chronic hepatitis C virus infection in Hong Kong and to estimate the service gap for achieving the WHO hepatitis elimination targets of attaining a diagnosis rate of 90%, treatment rate of 80% and 65% reduction in mortality rate by 2030. METHODS: From January 2005 to March 2017, patients who were tested positive for anti-HCV were retrospectively retrieved from all public hospitals in Hong Kong. The epidemiological data of 15 participating hospitals were analysed. RESULTS: A total of 11 309 anti-HCV+ patients were identified and the estimated diagnosis rate was 50.9%. Our HCV-infectedpatients were ageing (median age 59). The all-cause mortality rate increased from 26.2 to 54.8 per 1000 person-years over the last decade. Our estimated treatment rate was 12.4%. Among the treated patients, 93.6% had received pegylated interferon/ribavirin (Peg-IFN/RBV) but only 10.8% had received interferon-free direct-acting antivirals (DAAs). In a cohort of 1533 patients, 39% already had advanced liver fibrosis or cirrhosis. The sustained virological response rate for Peg-IFN/RBV and DAAs were 74.8% and 97.2% respectively. However, more than 70% of patients were not subjected to interferon treatment for various reasons. Patients who achieved SVR were associated with a significantly lower risk of HCC (4.7% vs 9.6%, P = 0.005) and death (1.7% vs 23.8%, P < 0.001). CONCLUSION: Our diagnosis rate, treatment rate and mortality rate reduction were still low, particularly the Peg-IFN outcomes, making it difficult to meet the WHO hepatitis elimination targets. A more generalized use of DAAs is urgently needed to improve the situation.
Authors: Man-Fung Yuen; Sze-Hang Liu; Wai-Kay Seto; Lung-Yi Mak; Shelby L Corman; Danny C Hsu; Mary Y K Lee; Tsz K Khan; Amy Puenpatom Journal: Dig Dis Sci Date: 2020-05-08 Impact factor: 3.199
Authors: Siddharth Sridhar; Cyril C Y Yip; Nicholas F S Chew; Shusheng Wu; Kit-Hang Leung; Jasper F W Chan; Vincent C C Cheng; Kwok-Yung Yuen Journal: Open Forum Infect Dis Date: 2019-07-12 Impact factor: 3.835