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Schwarz C, Bauer D, Dorn L, Jachs M, Hartl L, Chromy D, Weseslindtner L, Pfisterer N, Hennlich B, Stückler A, Strassl R, Voill-Glaninger A, Hübl W, Willheim M, Köhrer K, Jansen-Skoupy S, Tomez S, Krugluger W, Madl C, Schwarz M, Balcar L, Semmler G, Brinkmann L, Burghart L, Antonitsch L, Weidinger G, Riedl F, Laferl H, Kurteva V, Traugott M, Hind J, Wenisch C, Aburaia A, Sebesta C, Schmid D, Rothweiler S, Remetic J, Gschwantler M, Maieron A, Reiberger T. ELIMINATE: a PCR record-based macroelimination project for systematic recall of HCV-RNA-positive persons in Austria. Wien Klin Wochenschr 2024; 136:278-288. [PMID: 37773541 PMCID: PMC11078856 DOI: 10.1007/s00508-023-02275-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 08/23/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND AND AIMS Micro-elimination projects targeted to specific hepatitis C virus (HCV) risk populations have been successful. Systematic identification of persons with HCV viremia, regardless of risk group, based on already available laboratory records may represent an effective macroelimination approach to achieve global HCV elimination. METHODS Persons with a last positive HCV-RNA PCR result between 2008-2020 in the reference virology laboratories in eastern Austria were identified. First, (i) we described their demographic characteristics, (ii) we systematically recalled persons to the respective centers and (iii) started antiviral treatment if HCV-RNA viremia was confirmed, and (iv) recorded sustained virologic response (SVR). This interim report includes the preliminary results from 8 participating centers. RESULTS During the study period 22,682 persons underwent HCV-RNA PCR testing, 11,216 (49.4%) were positive at any point in time, and 6006 (26.5%) showed detectable HCV-RNA at the last PCR test, suggesting ongoing HCV viremia. At the time of this interim report, 2546/6006 HCV-RNA PCR(+) persons were evaluated: 443/2546 (17.4%) had died, 852/2546 (33.5%) had invalid contact data, and 547/2546 (21.5%) had achieved SVR between data retrieval and recall. Contact could be established in 236/704 (33.5%) of the remaining target population with 97/236 (41.1%) presenting at the clinic for treatment evaluation. Ultimately, 71/236 (30.1%) started antiviral treatment and SVR was documented in 47/71 (66.2%). CONCLUSION This ELIMINATE project based on systematic assessment of HCV-RNA PCR-records, identified 6006 persons with potential persisting HCV viremia. Invalid contact data and missed visits for treatment evaluation were the main barriers towards HCV elimination within this project. Importantly, many subjects with HCV viremia lost to follow-up were successfully linked to care and started antiviral treatment.
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Affiliation(s)
- Caroline Schwarz
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria
| | - David Bauer
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria
| | - Livia Dorn
- Internal Medicine 2, Gastroenterology and Hepatology and Rheumatology, Karl Landsteiner University of Health Sciences, University Hospital of St. Pölten, St. Pölten, Austria
| | - Mathias Jachs
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
| | - Lukas Hartl
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
| | - David Chromy
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Nikolaus Pfisterer
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine IV, Klinik Landstraße, Vienna, Austria
| | - Barbara Hennlich
- Department of Internal Medicine IV, Klinik Landstraße, Vienna, Austria
| | - Annika Stückler
- Department of Internal Medicine IV, Klinik Landstraße, Vienna, Austria
| | - Robert Strassl
- Clinical Institute for Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Wolfgang Hübl
- Central Laboratory, Klinik Ottakring, Vienna, Austria
| | - Martin Willheim
- Clinical Institute of Laboratory Medicine, University Clinic St. Pölten, St. Pölten, Austria
| | - Karin Köhrer
- Institute of Medical-Chemical and Molecularbiological Laboratory Diagnostics with Blood Depot, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | | | - Sabine Tomez
- Institute of Laboratory Medicine with Blood Depot, Klinik Donaustadt, Vienna, Austria
| | - Walter Krugluger
- Institute of Laboratory Medicine with Blood Depot, Klinik Donaustadt, Vienna, Austria
- Institute of Laboratory Medicine and Blood Depot, Klinik Floridsdorf, Vienna, Austria
| | - Christian Madl
- Department of Internal Medicine IV, Klinik Landstraße, Vienna, Austria
- Sigmund Freud University, Vienna, Austria
| | - Michael Schwarz
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria
| | - Lorenz Balcar
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
| | - Georg Semmler
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
| | - Leonard Brinkmann
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria
| | - Lukas Burghart
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria
- Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria
| | - Lukas Antonitsch
- Department of Internal Medicine, Gastroenterology and Hepatology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Gerhard Weidinger
- Department of Internal Medicine, Gastroenterology and Hepatology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Florian Riedl
- Internal Medicine 2, Gastroenterology and Hepatology and Rheumatology, Karl Landsteiner University of Health Sciences, University Hospital of St. Pölten, St. Pölten, Austria
| | - Hermann Laferl
- Department of Internal Medicine IV, Klinik Favoriten, Vienna, Austria
| | - Vesselina Kurteva
- Department of Internal Medicine IV, Klinik Favoriten, Vienna, Austria
| | - Marianna Traugott
- Department of Internal Medicine IV, Klinik Favoriten, Vienna, Austria
| | - Julian Hind
- Department of Internal Medicine IV, Klinik Favoriten, Vienna, Austria
| | - Christoph Wenisch
- Department of Internal Medicine IV, Klinik Favoriten, Vienna, Austria
| | - Abdelrahman Aburaia
- Department of Internal Medicine and Gastroenterology, Klinik Floridsdorf, Vienna, Austria
| | - Christian Sebesta
- Department of Internal Medicine and Gastroenterology, Klinik Floridsdorf, Vienna, Austria
- Department of Internal Medicine II, Klinik Donaustadt, Vienna, Austria
| | - Daniela Schmid
- Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH (AGES), Vienna, Austria
| | | | | | - Michael Gschwantler
- Department of Internal Medicine IV, Klinik Ottakring, Vienna, Austria
- Sigmund Freud University, Vienna, Austria
| | - Andreas Maieron
- Internal Medicine 2, Gastroenterology and Hepatology and Rheumatology, Karl Landsteiner University of Health Sciences, University Hospital of St. Pölten, St. Pölten, Austria
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
- Vienna HIV & Liver Study Group, Medical University of Vienna, Vienna, Austria.
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