In-Hospital Screening Campaign Against Hepatitis C Could Be Effective for Identifying More Patients Who Still Need Treatment

Abstract

Background

Screening programmes for the detection of patients with hepatitis C virus (HCV) and positive viral load have been developed in many countries to achieve the World Health Organization's goal of HCV elimination by 2030. In Italy, a phased screening programme starting with individuals born between 1969 and 1989 has been implemented.

Aim

To assess the prevalence of patients with positive viraemia identified through a universal screening campaign conducted among hospitalised patients at our centre during the calendar year 2022.

Methods

All adult (aged ≥ 18 years) hospitalised patients, who participated in HCV screening from January to December 2022 were included, without any age restriction. Screening initially involved testing for anti-HCV antibodies and then patients who tested positive underwent further HCV-RNA testing.

Results

A total of 10,846 samples were collected. Five hundred and thirty cases (4.8%) tested positive for HCV antibodies, and 109 (1%) tested positive for both HCV antibodies and HCV-RNA. Among patients with a positive viral load, the median [IQR] age was 62 [53–77] years, with a significant age difference between males and females (59 [48–67] vs. 78 [62–88]; Mann–Whitney U-test, p = 0.001). Eighty-four (77%) patients with a positive viral load were outside the target age range specified in the current National Recommendations for free-of-charge screening.

Conclusions

The non-negligible prevalence of patients with a positive viral load among an unselected group of hospitalised patients suggests that such settings could effectively enhance screening programmes aimed at HCV elimination. Additionally, this approach may help identify patients who are not currently included in the National Recommendations.