P-84 IMPLEMENTATION OF A STEP-BY-STEP STRATEGY BASED ON THE TREATMENT CASCADE TO ELIMINATE HEPATITIS C VIRUS INFECTION IN THE HOSPITAL CENTRAL DE LAS FUERZAS ARMADAS FROM URUGUAY. PRELIMINARY REPORT
Juan Otegui, Victoria Mainardi, Daniela Olivari, Ana Fernández, Carolina Ferreira, Solange Gerona
Servicio de Enfermedades Hepáticas, Centro Nacional Hepato-Bilio-Pancreático (UDA), Programa Nacional de Traslpante Hepático, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay
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PRELIMINARY REPORT" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Juan Otegui, Victoria Mainardi, Daniela Olivari, Ana Fernández, Carolina Ferreira, Solange Gerona" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Juan" "apellidos" => "Otegui" ] 1 => array:2 [ "nombre" => "Victoria" "apellidos" => "Mainardi" ] 2 => array:2 [ "nombre" => "Daniela" "apellidos" => "Olivari" ] 3 => array:2 [ "nombre" => "Ana" "apellidos" => "Fernández" ] 4 => array:2 [ "nombre" => "Carolina" "apellidos" => "Ferreira" ] 5 => array:2 [ "nombre" => "Solange" "apellidos" => "Gerona" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Enfermedades Hepáticas, Centro Nacional Hepato-Bilio-Pancreático (UDA), Programa Nacional de Traslpante Hepático, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay" "identificador" => "aff0001_100366_81" ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="para9001_100366_81" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="fig0001_100366_81"></elsevierMultimedia></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "<span id="abss0001_100366_81" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001_100366_81">Background</span><p id="spara001_100366_81" class="elsevierStyleSimplePara elsevierViewall">Strategies to achieve the World Health Organization target of eliminating hepatitis C virus (HCV) infection by 2030 (diagnosis of 90% of chronically infected persons and treatment of 80%) are required.</p></span> <span id="abss0002_100366_81" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002_100366_81">Objectives</span><p id="spara003_100366_81" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">1)</span>  Determinate the status of HCV infection in the Hospital Central de las Fuerzas Armadas (HCFFAA) from Uruguay</p><p id="spara004_100366_81" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">2)</span>  Implement and evaluate a step-by-step elimination strategy.</p></span> <span id="abss0003_100366_81" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003_100366_81">Methods</span><p id="spara005_100366_81" class="elsevierStyleSimplePara elsevierViewall">A treatment cascade was constructed by:</p><p id="spara006_100366_81" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">A</span>  Estimation of the number of HCV chronic infection population of the HCFFA based on Uruguay prevalence (0,7%)</p><p id="spara007_100366_81" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">B</span>  Analyzing medical records of the Hepatology service (2000–2020).</p><p id="spara008_100366_81" class="elsevierStyleSimplePara elsevierViewall">The strategy consisted on contacting sequentially patients not cured:</p><p id="spara009_100366_81" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">1</span>.  HCV RNA confirmed</p><p id="spara010_100366_81" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">2.</span>  HCV antibody positive, RNA not tested</p></span> <span id="abss0004_100366_81" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004_100366_81">Results</span><p id="spara012_100366_81" class="elsevierStyleSimplePara elsevierViewall">1.008 chronically HCV infected people were estimated.</p><p id="spara013_100366_81" class="elsevierStyleSimplePara elsevierViewall">165 HCV antibody positive persons were detected, 30 were excluded (RNA negative).</p><p id="spara014_100366_81" class="elsevierStyleSimplePara elsevierViewall">Of the 135 left, 113 had RNA confirmation, 76 received treatments and 70 achieved sustained virological response (SVR).</p><p id="spara015_100366_81" class="elsevierStyleSimplePara elsevierViewall">Of 6 persons without SVR, 3 are currently on treatment and 3 could not be contacted.</p><p id="spara016_100366_81" class="elsevierStyleSimplePara elsevierViewall">Of 36 people RNA confirmed not treated, 20 were contacted: 10 were prescribed treatment and 10 were not candidate.</p><p id="spara017_100366_81" class="elsevierStyleSimplePara elsevierViewall">Of 22 HCV antibody positive people without RNA confirmation, 10 were contacted and RNA was requested (results pending).</p><p id="spara018_100366_81" class="elsevierStyleSimplePara elsevierViewall">Treatment prescription increased from 67 to 76% of HCV chronically infected RNA confirmed patients.</p></span> <span id="abss0005_100366_81" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0005_100366_81">Conclusion</span><p id="spara019_100366_81" class="elsevierStyleSimplePara elsevierViewall">Strategy implementation was successful improving access to treatment.</p><p id="spara020_100366_81" class="elsevierStyleSimplePara elsevierViewall">Active testing is the next step plan to overcome the barrier of patient unawareness of HCV infection.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abss0001_100366_81" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abss0002_100366_81" "titulo" => "Objectives" ] 2 => array:2 [ "identificador" => "abss0003_100366_81" "titulo" => "Methods" ] 3 => array:2 [ "identificador" => "abss0004_100366_81" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abss0005_100366_81" "titulo" => "Conclusion" ] ] ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0001_100366_81" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr9.jpeg" "Alto" => 910 "Ancho" => 1500 "Tamanyo" => 74208 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0001_100366_81" "detalle" => "Unlabelled imag" "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spara021_100366_81" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Fig. 1.</span> Treatment cascade for chronic hepatitis C virus infection in hepatology service of Hospital Central de las Fuerzas Armadas (Uruguay)</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/16652681/00000024000000S1/v3_202110260720/S1665268121001460/v3_202110260720/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/16652681/00000024000000S1/v3_202110260720/S1665268121001460/v3_202110260720/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268121001460?idApp=UINPBA00004N" ]
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