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Abstract Details
A global systematic review of hepatitis C elimination efforts through micro-elimination
Semin Liver Dis. 2022 Feb 21. doi: 10.1055/a-1777-6112. Online ahead of print.
Jeffrey V Lazarus12, Camila A Picchio2, Christopher Byrne3, Javier Crespo4, Massimo Colombo5, Graham Cooke6, Gregory J Dore7, Jason Grebely7, John W Ward8, John Dillon93
Author information
Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Health Systems & Infectious Diseases, Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Dundee, United Kingdom of Great Britain and Northern Ireland.
Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla. Research Institute Valdecilla-IDIVAL, Santander, Spain.
Department of Medicine, Humanitas Research Hospital, Rozzano, Italy.
Division of Infectious Diseases, Faculty of Medicine, Imperial College London, London, United Kingdom of Great Britain and Northern Ireland.
UNSW Sydney, The Kirby Institute, Sydney, Australia.
Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Atlanta, United States.
Department of Gastroenterology, Ninewells Hospital and Medical School, Dundee, United Kingdom of Great Britain and Northern Ireland.
Abstract
Micro-elimination targets specific sub-populations and/or geographic settings for hepatitis C virus (HCV) elimination. This review reports on global HCV micro-elimination literature published from 2013-2020. Data were extracted from publications to report a score based on the four key components defining micro-elimination. Sustained virologic response (SVR) and treatment initiation proportions were calculated for each manuscript and grouped means of these estimates were compared depending on micro-elimination score and care setting. 83% of the studies were from high-income settings and mainly included people who use drugs or those incarcerated. Among manuscripts, 18 had 'low' micro-elimination scores, 11 had 'high' scores and the differences in mean proportion who initiated treatment and achieved SVR between low and high score groups were statistically significant. Micro-elimination can be a useful complementary strategy for driving engagement in HCV treatment and cure. Our analysis suggests that adhering to more of the core micro-elimination components can improve outcomes.