Microelimination of hepatitis C in dialysis units: results from the Brazilian Registry for the elimination of HCV.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Abreu Patrícia Ferreira, Alves Pablo Rodrigues Costa, Bittencourt Paulo Lisboa, Calvo Isadora Cartaxo de Sousa, Vieira Neto Osvaldo Merege, Nascimento Marcelo Mazza do, Neves Felipe Costa, Moura Ana Flavia, Calazans Daniel Costa Chalabi, Salcedo Juan Miguel Villalobos, Rocha Cristina Melo, Lobato Cirley Maria de Oliveira, França Alex Vianey Callado, Pierre Alessandra Maria Mont'Alverne, Ferreira Adalgisa de Souza Paiva, Lopes Edmundo Pessoa, Medeiros Filho Jose Eymard Moraes de, Souto Francisco José Dutra, Aires Rodrigo Sebba, Mendes Liliana Sampaio Costa, Uehara Silvia Naomi de Oliveira, Gonçalves Luciana Lofego, Carmo Lilian Pires de Freitas do, Ivantes Cláudia Alexandra Pontes, Cheinquer Hugo, Parreira Tatiara Bueno, Israel Karla Cristina Silva Petruccelli, Costa Verônica de Jesus Rodrigues Cardozo, Sousa Hivis da Costa, Nasserala Jarinne Camilo Landim, Bastos Kleyton de Andrade, Pinheiro Maria Eliete, Silva Artur Quintiliano Bezerra da, Oliveira Claudia Maria Costa de, Barros Flávio Henrique Soares, Dourado Marclébio Manuel Coêlho, Costa Ciro Bruno, Mothé Ricardo Araújo, Cabral Alexandre Silvestre, Simão Denise Rodrigues, Barreto Fellype de Carvalho, Fraxino Paulo Henrique, Constancio Natasha Silva, Silva Dirceu Reis da, Silva Filho Álvaro Pacheco, Moura Lúcio Roberto Requião, Machado David Jose de Barros, Brabo Alexandre Minetto, Naseri Alice Pignaton, Carvalho Tomás Ribeiro, Pestana Nathalia da Fonseca, Rocha Pedro Tulio Monteiro de Castro E Abreu, Lima Leila Maria Soares Tojal de Barros, Perez Renata M, Narciso-Schiavon Janaina Luz, Andrade Antônio Ricardo Cardia Ferraz de, Zawadzki Bruno, Moura-Neto José A, Ferraz Maria Lucia Gomes
Аннотация
METHODS: This national, multicenter, prospective implementation study was conducted within the framework of the Brazilian Registry for the Elimination of HCV in Dialysis Units. All 904 active dialysis units in the country were invited; 384 (42.5%) joined voluntarily, and, within each, all eligible patients were enrolled (census) between 2021 and 2024. The HCV cascade of care was evaluated, including serological screening (anti-HCV), virological confirmation (HCV-RNA), treatment with direct-acting antivirals (DAAs), and assessment of sustained virologic response (SVR).
RESULTS: A total of 66,601 patients were evaluated, yielding a national anti-HCV prevalence of 2.08%. HCV-RNA testing coverage reached 65.4%, with a positivity rate of 64.2% among those tested, resulting in an adjusted prevalence of active viremia of 1.34%. Among patients with detectable viremia, 74.2% initiated antiviral therapy, 92.6% completed treatment, and 93.3% achieved SVR. The main barriers identified along the cascade of care included limited availability of diagnostic tests and patient mortality.
DISCUSSION: These findings indicate that Brazil has achieved robust therapeutic effectiveness indicators, placing the country at an advanced stage toward HCV elimination within the dialysis population. Nonetheless, important operational gaps persist, particularly in diagnostic confirmation.
CONCLUSION: Elimination of HCV in dialysis units is an achievable goal in Brazil. Sustained success depends on maintaining universal screening, ensuring prompt treatment initiation for confirmed cases, and strengthening continuous integration between services.