HCV Screening in a Sicilian Centre: A Descriptive Cohort Profile

Hepatitis C virus (HCV) infection prevalence in Italy varies according to geographical areas and clusters of infection. Moreover, epidemiological studies are old, and the actual prevalence of HCV active infections is also affected by the use of direct-acting antiviral therapies (DAAs) that achieve sustained virologic response (SVR) in >95% of treated patients. We aimed to evaluate the prevalence of HCV infections in in- or outpatients referred to a Sicilian hospital.

The study was conducted in the Buccheri La Ferla Hospital, in Palermo (Sicily), from 1 November 2019 to March 2022. We consecutively screened for HCV infections all inpatients who were evaluated on admission to the ward and all outpatients who referred to the central laboratory. All patients were screened using serological detection of HCV antibodies.

In the entire cohort, 469 out of 15,550 patients (3%) showed anti-HCV positivity, and this rate progressively increased according to classes of age (0.4% for <40 yrs, 3% for 40-60 yrs, 4% for >60-80 yrs, and 6.4% for >80 yrs). Among patients with anti-HCV positivity, 44.3% were HCV-RNA negative, 39.2% had HCV-RNA not available, and 16.4% were HCV-RNA positive. In total, 44.1% of patients with HCV-RNA positivity underwent DAA-based antiviral therapy.

HCV screening programs can be useful in identifying infected patients at risk of liver disease progression and/or infection spreading. The implementation of laboratory strategies based on HCV reflex testing, the activation of dedicated linkage-to-care plans, and a focus on higher-risk groups could increase the effectiveness of screening programs.