Marcello Persico1, Mario Masarone1, Andrea Aglitti1, Ciro Armenante2, Aniello Giordano3, Angela Guardiola4, Gabriella Raimondi5, Carlo Contaldi6, Carmine Nigro7, Giustina Marena8, Antonio De Luna9. 1. Internal Medicine and Hepatology Unit, Department of Medicine and Surgery "Scuola Medica Salernitana", University of Salerno, Baronissi (Salerno), Italy. 2. Ser.T 40, Dipartimento Dipendenze ASL Salerno, Cava de'Tirreni (Salerno), Italy. 3. Ser.T 42-Distretto Sanitario 65, Dipartimento Dipendenze ASL Salerno, Battipaglia (Salerno), Italy. 4. Ser.T 43, Dipartimento Dipendenze ASL Salerno, Salerno, Italy. 5. Ser.T 41-Distretto Sanitario 60, Dipartimento Dipendenze ASL Salerno, Nocera Inferiore (Salerno), Italy. 6. Ser.T 48, Dipartimento Dipendenze Asl Salerno, Sapri (Salerno), Italy. 7. Ser.T 45, Dipartimento Dipendenze ASL Salerno, Agropoli (Salerno), Italy. 8. Ser.T 47, Dipartimento Dipendenze ASL Salerno, Sant'Arsenio (Salerno), Italy. 9. Dipartimento Dipendenze ASL Salerno, Salerno, Italy.
Abstract
BACKGROUND AND AIMS: People who use drugs (PWUD) represent an active reservoir of HCV infection. The prevalence of chronic HCV infection in PWUD in Italy remains unknown because of the lack of systematic screening. Thanks to direct-acting antiviral agents (DAAs), hepatitis C can now be cured in most patients. Thus, the next challenge is to provide linkage-to-care for these patients. METHODS: In this scenario, we conducted a screening programme in PWUD attending seven Addiction Centers in Southern Italy, as well as a treatment programme in the Liver Unit of the University Hospital of Salerno. We used the OraQuick HCV antibody test to screen the PWUD (from 1 April to 30 September 2018). RESULTS: 593 subjects were consecutively enrolled in the programme; 250 (41.8%) were HCV-Ab-positive. 143 (24.1%) were aware of their infection and had been HCV-RNA-tested: 83 were positive and 60 negative. The remaining 107 subjects (18.1%) had never previously been tested and were unaware of their infection. A total of 160 (26.9%) HCV RNA-positive patients were found and offered antiviral therapy with DAAs. The sustained virological response rate was 98.5% and no adverse events were recorded. Two patients voluntarily discontinued treatment. No reinfections have been recorded to date. CONCLUSIONS: The prevalence of HCV-Ab positivity was high in the PWUDs enrolled in this study, and almost half the patients were unaware of being HCV-positive. The linkage-to-care provided was safe and effective, and no case of reinfection was recorded.
BACKGROUND AND AIMS: People who use drugs (PWUD) represent an active reservoir of HCV infection. The prevalence of chronic HCV infection in PWUD in Italy remains unknown because of the lack of systematic screening. Thanks to direct-acting antiviral agents (DAAs), hepatitis C can now be cured in most patients. Thus, the next challenge is to provide linkage-to-care for these patients. METHODS: In this scenario, we conducted a screening programme in PWUD attending seven Addiction Centers in Southern Italy, as well as a treatment programme in the Liver Unit of the University Hospital of Salerno. We used the OraQuick HCV antibody test to screen the PWUD (from 1 April to 30 September 2018). RESULTS: 593 subjects were consecutively enrolled in the programme; 250 (41.8%) were HCV-Ab-positive. 143 (24.1%) were aware of their infection and had been HCV-RNA-tested: 83 were positive and 60 negative. The remaining 107 subjects (18.1%) had never previously been tested and were unaware of their infection. A total of 160 (26.9%) HCV RNA-positive patients were found and offered antiviral therapy with DAAs. The sustained virological response rate was 98.5% and no adverse events were recorded. Two patients voluntarily discontinued treatment. No reinfections have been recorded to date. CONCLUSIONS: The prevalence of HCV-Ab positivity was high in the PWUDs enrolled in this study, and almost half the patients were unaware of being HCV-positive. The linkage-to-care provided was safe and effective, and no case of reinfection was recorded.
Authors: Lara Grau-López; Cristina Marcos-Fosch; Constanza Daigre; Raúl Felipe Palma-Alvarez; Ariadna Rando-Segura; Jordi Llaneras; Marta Perea-Ortueta; Francisco Rodriguez-Frias; Nieves Martínez-Luna; Mar Riveiro-Barciela; Josep Antoni Ramos-Quiroga; Joan Colom; Rafael Esteban; María Buti Journal: Therap Adv Gastroenterol Date: 2021-08-27 Impact factor: 4.409