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Isfordink CJ, Smit C, Boyd A, de Regt MJA, Rijnders BJA, van Crevel R, Ackens RP, Reiss P, Arends JE, van der Valk M. Low hepatitis C virus-viremia prevalence yet continued barriers to direct-acting antiviral treatment in people living with HIV in the Netherlands. AIDS 2022; 36:773-783. [PMID: 34999607 DOI: 10.1097/qad.0000000000003159] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To describe hepatitis C virus (HCV)-viremia prevalence and barriers to direct-acting antiviral (DAA) treatment during unrestricted access to DAA in a nationwide cohort of people with HIV (PWH). DESIGN Retrospective analysis of prospectively collected data. METHODS We calculated yearly HCV-viremia prevalence as proportion of HCV RNA-positive individuals ever HCV-tested. We then included HCV-viremic individuals with ≥1 visit during the era of universal DAA-access (database lock = December 31, 2018). Based on their last visit, individuals were grouped as DAA-treated or -untreated. Variables associated with lack of DAA-treatment were assessed using targeted maximum likelihood estimation. In November 2020, physicians of DAA-untreated individuals completed a questionnaire on barriers to DAA-uptake and onward HCV-transmission risk. RESULTS Among 25 196 PWH, HCV-viremia decreased from 4% to 5% between 2000 and 2014 to 0.6% in 2019. Being DAA-untreated was associated with HIV-transmission route other than men who have sex with men, older age, infrequent follow-up, severe alcohol use, detectable HIV-RNA, HCV-genotype 3, and larger hospital size. With universal DAA-access, 72 of 979 HCV-viremic individuals remained DAA-untreated at their last visit. Of these, 39 were no longer in care, 27 remained DAA-untreated in care, and six initiated DAA since database lock. Most common physician-reported barriers to DAA-uptake were patient refusal (20/72, 28%) and infrequent visit attendance (19/72, 26%). Only one DAA-untreated individual in care was engaging in activities associated with onward HCV-transmission. CONCLUSIONS Prevalence of HCV-viremic PWH is low in the Netherlands, coinciding with widespread DAA-uptake. Barriers to DAA-uptake appear mostly patient-related, while HCV-transmission seems unlikely from the few DAA-untreated in care.
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Affiliation(s)
- Cas J Isfordink
- Department of Internal Medicine and Infectious Diseases, UMC Utrecht, Utrecht
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam
| | | | - Anders Boyd
- Stichting HIV Monitoring, Amsterdam
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam
| | - Marieke J A de Regt
- Department of Internal Medicine and Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Amsterdam
| | - Bart J A Rijnders
- Department of Internal Medicine, Section Infectious Diseases, Erasmus MC, University Medical Center, Rotterdam
| | - Reinout van Crevel
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen
| | - Robin P Ackens
- Department of Internal Medicine, Division of Infectious Diseases, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Peter Reiss
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam
- Stichting HIV Monitoring, Amsterdam
| | - Joop E Arends
- Department of Internal Medicine and Infectious Diseases, UMC Utrecht, Utrecht
| | - Marc van der Valk
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam
- Stichting HIV Monitoring, Amsterdam
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Humanes-Navarro AM, Herrador Z, Redondo L, Cruz I, Fernández-Martínez B. Estimating human leishmaniasis burden in Spain using the capture-recapture method, 2016-2017. PLoS One 2021; 16:e0259225. [PMID: 34714890 PMCID: PMC8555825 DOI: 10.1371/journal.pone.0259225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022] Open
Abstract
Leishmaniasis is endemic and a mandatory reporting disease in Spain since 1982. However, between 1996 and 2014, surveillance on public health was decentralized and only some autonomous regions monitored the disease. The aim of this study is to estimate the incidence of leishmaniasis and to evaluate the extent of underreporting in Spain. A capture-recapture (CRC) study was conducted to calculate the incidence of human leishmaniasis using reports from the National Surveillance Network (RENAVE) and the Hospital Discharge Records of the National Health System (CMBD) for 2016 and 2017. During the study period, 802 cases were reported to RENAVE and there were 1,149 incident hospitalizations related to leishmaniasis. The estimated incidence rates through the CRC study were 0.79 per 100,000 inhabitants for visceral leishmaniasis (VL), 0.88 (cutaneous leishmaniasis (CL)) and 0.12 (mucocutaneous leishmaniasis (MCL)) in 2016 and 0.86 (VL), 1.04 (CL) and 0.12 (MCL) in 2017. An underreporting of 14.7-20.2% for VL and 50.4-55.1% for CL was found. The CRC method has helped us to assess the sensitivity and representativeness of leishmaniasis surveillance in Spain, being a useful tool to assess whether the generalization of leishmaniasis surveillance throughout the Spanish territory achieves a reduction in underreporting.
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Affiliation(s)
| | - Zaida Herrador
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
| | - Lidia Redondo
- Network Biomedical Research on Tropical Diseases (RICET in Spanish), Madrid, Spain
- National Centre for Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Israel Cruz
- National School of Public Health, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Beatriz Fernández-Martínez
- National Centre for Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Kracht PAM, Arends JE, Hoepelman AIM, Kretzschmar MEE. Estimating regional prevalence of chronic hepatitis C with a capture-recapture analysis. BMC Infect Dis 2021; 21:640. [PMID: 34217261 PMCID: PMC8254300 DOI: 10.1186/s12879-021-06324-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background The hepatitis C virus (HCV) infection is a candidate disease for micro-elimination. Accurate baseline HCV prevalence estimation is essential to monitor progress to micro-elimination but can be methodologically challenging in low-endemic regions like the Netherlands due to lack of disaggregated data by age or risk-groups on the number of chronic HCV patients (i.e. HCV RNA positive). This study estimates the number of patients that has had a chronic HCV infection (ever-chronic) in the Utrecht region of the Netherlands. Methods In the Utrecht province in the Netherlands, positive HCV tests from the period 2001–2015 from one diagnostic center and four hospital laboratories were collected. A two-source capture-recapture method was used to analyze the overlap between the two registries (with 92% HCV RNA and 8% HCV immunoblot confirmed infections) to obtain the number of ever-chronic HCV infections in the Utrecht region. The Utrecht region was defined as an area with a 25 km radius from the Utrecht city center. The current viremic HCV prevalence was calculated by taking into account the proportion of cured and deceased HCV patients from a local HCV retrieval (REACH) project. Results The estimated number of ever-chronic HCV patients was 1245 (95% CI 1164–1326) and would indicate a prevalence of 0.10 (95% CI 0.09–0.10) in the Utrecht region. This is 30% (95% CI 21–38%) more than the number of known HCV patients in the records. The ever-chronic HCV prevalence was highest in the 1960–1969 age cohort (0.16; 95% CI 0.14–0.18). Since 50% of the HCV patients were cured or deceased in the REACH-project, the number of current viremic HCV patients was estimated at 623 individuals in the Utrecht region (prevalence 0.05%). Conclusion The results of this study suggest a low ever-chronic and current HCV prevalence in the Utrecht area in the Netherlands, but other studies need to confirm this. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06324-z.
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Affiliation(s)
- Patricia A M Kracht
- Department of Infectious Diseases, University Medical Center Utrecht, PO BOX 85500, 3508, Utrecht, GA, The Netherlands.
| | - Joop E Arends
- Department of Infectious Diseases, University Medical Center Utrecht, PO BOX 85500, 3508, Utrecht, GA, The Netherlands
| | - Andy I M Hoepelman
- Department of Infectious Diseases, University Medical Center Utrecht, PO BOX 85500, 3508, Utrecht, GA, The Netherlands
| | - Mirjam E E Kretzschmar
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Ohata PJ, Su Lwin HM, Han WM, Khwairakpam G, Tangkijvanich P, Matthews GV, Avihingsanon A. Elimination of hepatitis C among HIV-positive population in Asia: old and new challenges. Future Virol 2021. [DOI: 10.2217/fvl-2021-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hepatitis C virus (HCV) prevalence is high among people living with HIV co-infected with HCV, people who inject drugs, men who have sex with men and inmates in correctional settings. The barriers to eliminate HCV among these key populations include diagnosis challenges, lack of awareness, discrimination and stigmatization. In addition, scaling up of HCV treatment has been a challenge in Asia–Pacific with the lack of national policies, targets and unavailability of appropriate direct-acting antivirals regimens. In order to achieve HCV micro elimination within these high-risk populations, novel strategies to improve the cascade of care from diagnosis to treatment with direct-acting antivirals, complemented by behavioral change interventions, harm reduction services for people who inject drugs, civil society led advocacy and policies from the government, will be necessary.
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Affiliation(s)
- Pirapon June Ohata
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
| | - Hay Mar Su Lwin
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
| | - Win Min Han
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
| | - Giten Khwairakpam
- TREAT Asia, Exchange Tower, 388 Sukhumvit Road, Suite 2104, Klongtoey, Bangkok, 10110, Thailand
| | - Pisit Tangkijvanich
- Center of Excellence in Hepatitis & Liver Cancer, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Gail V Matthews
- The Kirby Institute, University of New South Wales, NSW, Sydney, 2052, Australia
| | - Anchalee Avihingsanon
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
- Tuberculosis Research Unit (TB RU), Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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Sansamur C, Wiratsudakul A, Charoenpanyanet A, Punyapornwithaya V. Estimating the number of farms experienced foot and mouth disease outbreaks using capture-recapture methods. Trop Anim Health Prod 2020; 53:12. [PMID: 33211202 DOI: 10.1007/s11250-020-02452-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
Foot and mouth disease (FMD) is recognized as an endemic disease in Thailand and throughout other countries in Southeast Asia. The underreporting of FMD outbreaks has affected the true status of the disease. This study aimed to determine the number of dairy farms in Chiang Mai that had experienced FMD outbreaks (FMD outbreak farm) during 2015-2016 using capture-recapture (CR) methods. Two independent FMD outbreak data sources including data from the livestock authorities and survey questionnaires were analyzed using Chapman estimator and Chao estimator. Results showed that the estimated number of FMD outbreak farms was 264 (95% CI = 250, 277) and 273 (95% CI = 259, 292) farms based on the Chapman estimator and Chao estimator, respectively. The estimated prevalence of FMD corresponding to the Chapman estimator was lower than the Chao estimator. The active approach of the survey method offered a higher degree of sensitivity compared to the passive method used by the livestock authorities. Estimations from the CR method provided an upper bound for the true number of outbreak farms. This study demonstrated the use of the CR method to estimate the true status of FMD outbreaks. Our proposed approach can potentially be used as a tool to enhance the accuracy and sensitivity of established monitoring and surveillance systems.
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Affiliation(s)
- Chalutwan Sansamur
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, 50100, Thailand
| | - Anuwat Wiratsudakul
- Department of Clinical Sciences and Public Health and The Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals, Faculty of Veterinary Science, Mahidol University, Phutthamonthon, Nakhon Pathom, 73170, Thailand
| | - Arisara Charoenpanyanet
- Department of Geography, Faculty of Social Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Veerasak Punyapornwithaya
- Veterinary Public Health and Food Safety Centre for Asia Pacific, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, 50100, Thailand.
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