EFFECTIVENESS OF DIAGNOSTICS AND ROUTINE FOLLOW-UP MONITORING IN CHRONIC HEPATITIS C
Abstract
Background. The emergence of new antiviral drugs has made it possible to eliminate the virus in more than 95% of patients with chronic hepatitis C. Improving diagnostics in primary health care aimed at the earliest possible detection of the disease is of primary importance in such a situation. Objective. To analyze the effectiveness of diagnostics and routine follow-up monitoring of patients with chronic hepatitis C in the Vitebsk region. Material and methods. We conducted a retrospective analysis of the incidence of HCV infection in the Vitebsk region during 2009-2020. We performed a comparative evaluation of ELISA and ICA/ICT techniques for the detection of HCV antibody. Results. It was found out that during the analyzed period there was a significant decrease in the incidence of various forms of HCV infection, accompanied by an increase in the proportion of chronic hepatitis C and a sharp decrease in the proportion of anti-HCV carriers, that can be regarded as a direct result of information campaigns designed for primary care providers. There were differences in the structure of HCV infection in various parts of the Vitebsk region. Rapid anti-HCV immunochromatography test showed equal effectiveness with a diagnostic sensitivity of 93.75% (CI = 69.9-99.8) and a specificity of 100% (CI = 82.4-100%) (AUC=0.969, p<0.0001) compared with ELISA. Conclusions. The nosological structure of HCV infection has significant differences in various parts of the Vitebsk region that can be related to diagnostics availability and quality. The use of ICA/ICT for anti-HCV detection during screening is regarded to be more commercially available and economically feasible.
References
Petruzziello A, Marigliano S, Loquercio G, Cozzolino A, Cacciapuoti C. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016;22(34):7824-40. https://doi.org/10.3748/wjg.v22.i34.7824.
Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61(1 Suppl):S45-57. https://doi.org/10.1016/j.jhep.2014.07.027.
Sarrazin C. The importance of resistance to direct antiviral drugs in HCV infection in clinical practice. J Hepatol. 2016;64(2):486-504. https://doi.org/10.1016/j.jhep.2015.09.011.
Krassenburg LAP, Maan R, Ramji A, Manns MP, Cornberg M, Wedemeyer H, de Knegt RJ, Hansen BE, Janssen HLA, de Man RA, Feld JJ, van der Meer AJ. Clinical outcomes following DAA therapy in patients with HCV-related cirrhosis depend on disease severity. J Hepatol. 2021;74(5):1053-1063. https://doi.org/10.1016/j.jhep.2020.11.021.
Lingala S, Ghany MG. Natural History of Hepatitis C. Gastroenterol Clin North Am. 2015;44(4):717-34. https://doi.org/10.1016/j.gtc.2015.07.003.
Chevaliez S, Wlassow M, Volant J, Roudot-Thoraval F, Bachelard A, Poiteau L, Trabut JB, Hézode C, Bourdel A, Dominguez S. Assessing Molecular Point-of-Care Testing and Dried Blood Spot for Hepatitis C Virus Screening in People Who Inject Drugs. Open Forum Infect Dis. 2020;7(6):ofaa196. https://doi.org/10.1093/ofid/ofaa196.
1.png)
