Hepatitis C virus (HCV) elimination by 2030, using direct-acting antiviraltreatments, has been promoted by the World Health Organization. Thisachievement is not attainable, however, particularly after the 2020 pandemi...Hepatitis C virus (HCV) elimination by 2030, using direct-acting antiviraltreatments, has been promoted by the World Health Organization. Thisachievement is not attainable, however, particularly after the 2020 pandemic ofthe coronavirus disease 2019. Consequently, the more realistic objective ofeliminating HCV from population segments for which targeted strategies ofprevention and treatment are easily attained has been promoted in Europe, as avalid alternative. The underlying idea is that micro-elimination will ultimatelylead to macro-elimination. The micro-elimination strategy may target differentspecific populations and at-risk groups. Different settings, including prisons andhospitals, have also been identified as micro-elimination scenarios. In addition,dedicated micro-elimination strategies have been designed that are tailored at thegeographical level according to HCV epidemiology and individual country’sincome. The main elements of a valid and successful micro-elimination project arereliable epidemiological data and active involvement of all the stakeholders.Community involvement represents another essential component for a successfulprogram.展开更多
Liver injury has been reported in coronavirus disease 2019(COVID-19)cases but the impact of pre-existing liver damage and related etiology have not been completely elucidated.Our research interests include the potenti...Liver injury has been reported in coronavirus disease 2019(COVID-19)cases but the impact of pre-existing liver damage and related etiology have not been completely elucidated.Our research interests include the potential reciprocal influence of COVID-19 and pre-existing liver damage related to hepatitis C virus(HCV)infection,in particular.To this end,we have evaluated three cohorts of patients admitted at three Italian hospitals during the coronavirus pandemic;these included 332 patients with COVID-19 and 1527 patients with HCV who were from established real-world antiviral treatment study cohorts(sofosbuvir/velpatasvir),with either liver disease(various severities;n=1319)or cirrhosis(n=208).Among the COVID-19 patients,10 had cirrhosis(3%),including 7 of metabolic origin and 3 of viral origin.Mortality among the COVID-19 patients was 27.1%,with 70%of those with cirrhosis of metabolic etiology having died.Cirrhosis,older age,low white blood cell count and lymphocyte count being identified as risk predictors of death[odds ratio(OR)=13.7,95%confidence interval(CI):2.59-83.01,P=0.006;OR=1.05,95%CI:1.03-1.08,P=0.0001;OR=1.09,95%CI:1.36-1.16,P=0.001;OR=0.61,95%CI:0.39-0.93,P=0.023,respectively].In the two cohorts of HCV patients,COVID-19 diagnosis was made in 0.07%of those with liver disease and 1%of those with cirrhosis.Thus,the prevalence of HCV antibodies among COVID-19-infected patients was comparable to that currently reported for the general population in Italy.Amongst the COVID-19 patients,pre-existing metabolic cirrhosis appears to be associated with higher mortality,while HCV antibodies may be suggestive of“protection”against COVID-19.展开更多
文摘Hepatitis C virus (HCV) elimination by 2030, using direct-acting antiviraltreatments, has been promoted by the World Health Organization. Thisachievement is not attainable, however, particularly after the 2020 pandemic ofthe coronavirus disease 2019. Consequently, the more realistic objective ofeliminating HCV from population segments for which targeted strategies ofprevention and treatment are easily attained has been promoted in Europe, as avalid alternative. The underlying idea is that micro-elimination will ultimatelylead to macro-elimination. The micro-elimination strategy may target differentspecific populations and at-risk groups. Different settings, including prisons andhospitals, have also been identified as micro-elimination scenarios. In addition,dedicated micro-elimination strategies have been designed that are tailored at thegeographical level according to HCV epidemiology and individual country’sincome. The main elements of a valid and successful micro-elimination project arereliable epidemiological data and active involvement of all the stakeholders.Community involvement represents another essential component for a successfulprogram.
文摘Liver injury has been reported in coronavirus disease 2019(COVID-19)cases but the impact of pre-existing liver damage and related etiology have not been completely elucidated.Our research interests include the potential reciprocal influence of COVID-19 and pre-existing liver damage related to hepatitis C virus(HCV)infection,in particular.To this end,we have evaluated three cohorts of patients admitted at three Italian hospitals during the coronavirus pandemic;these included 332 patients with COVID-19 and 1527 patients with HCV who were from established real-world antiviral treatment study cohorts(sofosbuvir/velpatasvir),with either liver disease(various severities;n=1319)or cirrhosis(n=208).Among the COVID-19 patients,10 had cirrhosis(3%),including 7 of metabolic origin and 3 of viral origin.Mortality among the COVID-19 patients was 27.1%,with 70%of those with cirrhosis of metabolic etiology having died.Cirrhosis,older age,low white blood cell count and lymphocyte count being identified as risk predictors of death[odds ratio(OR)=13.7,95%confidence interval(CI):2.59-83.01,P=0.006;OR=1.05,95%CI:1.03-1.08,P=0.0001;OR=1.09,95%CI:1.36-1.16,P=0.001;OR=0.61,95%CI:0.39-0.93,P=0.023,respectively].In the two cohorts of HCV patients,COVID-19 diagnosis was made in 0.07%of those with liver disease and 1%of those with cirrhosis.Thus,the prevalence of HCV antibodies among COVID-19-infected patients was comparable to that currently reported for the general population in Italy.Amongst the COVID-19 patients,pre-existing metabolic cirrhosis appears to be associated with higher mortality,while HCV antibodies may be suggestive of“protection”against COVID-19.
