Evaluation of a strategy for identification of hepatitis C virus carriers in outpatient and emergency units: contribution to the microelimination of hepatitis C in Brazil

• Autor(a) principal: Gardona,Rodrigo
• Data de Publicação: 2021
• Outros Autores: Appel,Flavia, Ercolin,Samara, Carvalho-Filho,Roberto J., Barbosa,Dulce A., Ferraz,Maria Lucia
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Infectious Diseases
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702021000200203
• topic: Hepatitis C; HCV; Rapid tests; Emergency unit

ABSTRACT Introduction: Hepatitis C virus (HCV) infection continues to be an important public health problem worldwide. Despite the availability of drugs that promote the cure of infection in more than 95% of cases, the identification of HCV carriers remains a major challenge. Objective: To evaluate a strategy for identifying HCV carriers based on combined criteria: screening in emergency units and specialty outpatient clinics of a tertiary hospital and among older adults (≥45 years), both suggested as efficient in epidemiological studies. Methods: A cross-sectional, analytical and descriptive study was conducted on individuals of both sexes, aged 45 years and older, attending the emergency department and specialty outpatient clinics of a University Hospital in São Paulo, Brazil, from January 2016 to June 2018. After giving formal consent, the patients were submitted to a standardized interview and rapid testing for the identification of HCV antibodies (SD BIOLINE® anti-HCV). Results: A total of 606 adult patients (62% women and 37% men) were evaluated. The mean age was 62 ± 10 years. Four positive tests were identified, with confirmation by conventional serology and HCV-RNA determination. Thus, the prevalence of HCV identified in the sample was 0.66%. All patients had a history of risk factors for infection. Conclusion: The strategies of birth-cohort testing and screening in emergency medical services for the identification of HCV carries, both suggested in the literature as efficient for the diagnosis of hepatitis C, resulted in a low rate of HCV infection. These findings highlight the magnitude of the challenge of identifying asymptomatic HCV carriers in Brazil.