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Territory-wide population-based study of chronic hepatitis C infection and implications for hepatitis elimination in Hong Kong.

Hui, Yee Tak; Wong, Grace L H; Fung, James Y Y; Chan, Henry L Y; Leung, Nancy W Y; Liu, Sienna D; Liu, Ken; Ma, Yiu Keung; But, David Y K; Mak, Wing Yan; Chan, Jacky M C; Lai, Kin Bon; Loo, Ching Kong; Ng, Annie C Y; Lai, Moon Sing; Chan, Chun Wing; Lau, Joulen Y L; Fan, Tina T T; Hui, Aric J; Lam, Belsy C Y; Cheung, Wing I; Tsang, Owen T Y; Lam, Karen; Lai, Lawrence S W; Luk, Wai Fan; Li, Michael K K; Lao, Wai Cheung; Lam, Jodis T W; Tsang, Steven W C; Kung, Kam Ngai; Chow, Wai Hung; Tong, Ronald K N; Lui, Thomas K L; Shan, Edwin H S; Yuen, Man Fung; Wong, Vincent W S.
Liver Int; 38(11): 1911-1919, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29981176

BACKGROUND:

To study the epidemiology of chronic hepatitis C virus infection in Hong Kong and to estimate the service gap for achieving the WHO hepatitis elimination targets of attaining a diagnosis rate of 90%, treatment rate of 80% and 65% reduction in mortality rate by 2030.

METHODS:

From January 2005 to March 2017, patients who were tested positive for anti-HCV were retrospectively retrieved from all public hospitals in Hong Kong. The epidemiological data of 15 participating hospitals were analysed.

RESULTS:

A total of 11 309 anti-HCV+ patients were identified and the estimated diagnosis rate was 50.9%. Our HCV-infected patients were ageing (median age 59). The all-cause mortality rate increased from 26.2 to 54.8 per 1000 person-years over the last decade. Our estimated treatment rate was 12.4%. Among the treated patients, 93.6% had received pegylated interferon/ribavirin (Peg-IFN/RBV) but only 10.8% had received interferon-free direct-acting antivirals (DAAs). In a cohort of 1533 patients, 39% already had advanced liver fibrosis or cirrhosis. The sustained virological response rate for Peg-IFN/RBV and DAAs were 74.8% and 97.2% respectively. However, more than 70% of patients were not subjected to interferon treatment for various reasons. Patients who achieved SVR were associated with a significantly lower risk of HCC (4.7% vs 9.6%, P = 0.005) and death (1.7% vs 23.8%, P < 0.001).

CONCLUSION:

Our diagnosis rate, treatment rate and mortality rate reduction were still low, particularly the Peg-IFN outcomes, making it difficult to meet the WHO hepatitis elimination targets. A more generalized use of DAAs is urgently needed to improve the situation.
Selo DaSilva