Year 2019 / Volume 111 / Number 11
Special Article
Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH)

862-873

DOI: 10.17235/reed.2019.6700/2019

Javier Crespo, Albillos Albillos, María Buti, José Luis Calleja, Javier García Samaniego, Manuel Hernández Guerra, Trinidad Serrano, Juan Turnes, Enrique Acín, Juan Berenguer, Marina Berenguer, Joan Colom, Inmaculada Fernández, Conrado Fernández Rodríguez, Xavier Forns, Federico García, Rafael Grandados, Jeffrey Lazarus, José María Molero, Esther Molina, Fernando Pérez Escanilla, Juan A. Pineda, Manuel Rodríguez, Manuel Romero, Carlos Roncero, Pablo Saiz de la Hoya, Gloria Sánchez Antolín,

Abstract
The Spanish Association for the Study of the Liver (AEEH) is convinced that the elimination of hepatitis C virus (HCV) in Spain is possible as long as we are able to use the resources and tools necessary for it. This document reflects the position of the AEEH regarding the elimination of HCV, establishing a wide range of recommendations that can be grouped into five categories: 1) Screening of HCV according to age, of the existence of classic acquisition risk factors of infection, active search of previously diagnosed patients and development of microelimination strategies in vulnerable populations; 2) Simplification of HCV diagnosis (one-step diagnosis and diagnosis at the point of patient care); 3) Simplification of patient treatment and improvement of care circuits; 4) Health policy measures, and, finally, 5) Establishment of HCV elimination indicators.
Share Button
New comment
Comments
No comments for this article
References
1. Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry JR, Cheinquer H, et al. Accelerating the elimination of viral hepatitis: A Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 2019;4:135-84. Fe de erratas: Lancet Gastroenterol Hepatol 2019;4(5):e4.
2. Chen Q, Ayer T, Bethea E, Kanwal F, Wang X, Roberts M, et al. Changes in hepatitis C burden and treatment trends in Europe during the era of direct-acting antivirals: A modelling study. BMJ Open 2019;9:e026726.
3. Aguinaga A, Díaz-González J, Pérez-García A, Barrado L, Martínez-Baz I, Casado I, et al. The prevalence of diagnosed and undiagnosed hepatitis C virus infection in Navarra, Spain, 2014-2016. Enferm Infecc Microbiol Clin 2018;36:325-31.
4. Cuadrado A, Llerena S, Escudero MD, Gómez M, Estébanez A, Puchades L, et al. Diseño y coste-efectividad de una política de eliminación del VHC basada en un estudio epidemiológico actualizado (cohorte Ethon). Gastroenterol Hepatol 2017. Congreso anual de la Asociación Española para el Estudio del Hígado (AEEH).
5. Rodríguez-Tajes SDY, Collazos C, Frías MC, Vidal Benede MJ, Jané M, Domínguez A, et al. Estudio de prevalencia de infección por los virus hepatitis B y C en Catalun˜a. Gastroenterol Hepatol 2017. Congreso anual de la Asociación Española para el Estudio del Hígado (AEEH).
6. Fernández-Bermejo M, Íñiguez R, Mata P, Ferreira H, Gómez B, Mateos J, et al. Estudio de prevalencia de serología de hepatitis C en un área de salud con población rural. Gastrenterol Hepatol 2017. Congreso de la Asociación Española para el Estudio del Hígado (AEEH).
7. Informe del Ministerio de Sanidad de Seroprevalencia del VHC en España. Disponible en: http://www.mscbs. gob.es/ciudadanos/enfLesiones/enfTransmisibles/sida/docs/INFORME INFECCION VHC ESPANA2019.pdf.
8. Juanbeltz R, Pérez-García A, Aguinaga A, Martínez-Baz I, Casado I, Burgui C, et al. Progress in the elimination of hepatitis C virus infection: A population-based cohort study in Spain. PLoS One 2018;13:e0208554.
9. Gómez-Escolar Viejo L, García Herola A, Sáez Lloret I, Sánchez Ruano F, Clemente Paulino I, Quílez Ivorra C, et al. Screening of hepatitis C virus infection in adult general population in Spain. Eur J Gastroenterol Hepatol 2018;30:1077-81, http://dx.doi.org/10.1097/MEG.0000000000001190.
10. Berenguer M, de la Rosa Rodríguez G, Domínguez Gil B. Significant impact of new oral therapies against HCV on the waiting list for liver transplantation in Spain. J Hepatol 2018;69:966-8.
11. OMS. Estrategia mundial del sector de la salud contra las hepatitis víricas 2016-2021. Hacia el fin de las hepatitis víricas. Junio de 2016.
12. Secretaría General de Sanidad y Consumo. Ministerio de Sanidad, Consumo y Bienestar Social. Plan Estratégico para el Abordaje de la Hepatitis C en el Sistema Nacional de Salud (PEAHC). Disponible en: https://www.mscbs.gob. es/ciudadanos/enfLesiones/enfTransmisibles/hepatitisC/PlanEstrategicoHEPATITISC/home.htm.
13. Mar J, Ibarrondo O, Martínez-Baz I, Juanbeltz R, San MR, Casado I, et al. Economic evaluation of a population strategy for the treatment of chronic hepatitis C with direct-acting antivirals. Rev Esp Enferm Dig 2018;110:621-8.
14. Turnes J, Domínguez-Hernández R, Casado MA. Value and innovation of direct-acting antivirals: Long-term health outcomes of the strategic plan for the management of hepatitis C in Spain. Rev Esp Enferm Dig 2017;109:809-17.
15. Oliva-Moreno J, Pena-Longobardo LM, Alonso S, Fernández-Bolaños A, Gutiérrez ML, Hidalgo-Vega A, et al. Labour productivity losses caused by premature death associated with hepatitis C in Spain. Eur J Gastroenterol Hepatol 2015;27:631-7.
16. Puig-Junoy J, Pascual-Argente N, Puig-Codina L, Planellas L, Solozabal M. Cost-utility analysis of second-generation directacting antivirals for hepatitis C: A systematic review. Expert Rev Gastroenterol Hepatol 2018;12:1251-63.
17. Buti M, Domínguez-Hernández R, Casado MA, Sabater E, Esteban R. Healthcare value of implementing hepatitis C screening in the adult general population in Spain. PLoS One 2018;13:e0208036.
18. Gómez-Escolar VL, García HA, Sáez L, Sánchez IRF, Clemente PI, Quilez IC, et al. Screening of hepatitis C virus infection in adult general population in Spain. Eur J Gastroenterol Hepatol 2018;30:1077-81.
19. Calleja JL, Macías J, Forns X, García F, Berenguer M, García Deltoro M, et al. Guidelines on treatment of hepatitis C virus infection. Spanish Association for the Study of the Liver (AEEH). Gastroenterol Hepatol 2018;41:597-608.
20. European Association for the Study of the Liver. EASL Recommendations on Treatment of Hepatitis C 2018. J Hepatol 2018;69:461-511.
21. AASLD-IDSA HCV Guidance Panel. Hepatitis C Guidance 2018 Update: AASLD-IDSA Recommendations for testing, managing, and treating hepatitis C virus infection. Clin Infect Dis 2018;67:1477-92.
22. World Health Organization. Guidelines for the screening care and treatment of persons with chronic hepatitis C infection: Updated version, April 2016. /20.
23. Van der Meer AJ, Feld JJ, Hofer H, Almasio PL, Calvaruso V, Fernández-Rodríguez CM, et al. Risk of cirrhosis-related complications in patients with advanced fibrosis following hepatitis C virus eradication. J Hepatol 2017;66:485-93.
24. Negro F, Forton D, Craxi A, Sulkowski MS, Feld JJ, Manns MP. Extrahepatic morbidity and mortality of chronic hepatitis C. Gastroenterology 2015;149:1345-60.
25. Pascual-Argente N, Puig-Junoy J, Llagostera-Punzano A. Nonhealthcare costs of hepatitis C: A systematic review. Expert Rev Gastroenterol Hepatol 2018;12:19-30.
26. Pascasio JM, Vinaixa C, Ferrer MT, Colmenero J, Rubin A, Castells L, et al. Clinical outcomes of patients undergoing antiviral therapy while awaiting liver transplantation. J Hepatol 2017;67:1168-76.
27. Strong K, Wald N, Miller A, Alwan A, WHO Consultation Group. Current concepts in screening for noncommunicable disease: World Health Organization Consultation Group Report on methodology of noncommunicable disease screening. J Med Screen 2005;12:12-9.
28. Harris R, Sawaya GF, Moyer VA, Calonge N. Reconsidering the criteria for evaluating proposed screening programs: Reflections from 4 current and former members of the U.S Preventive Services Task Force. Epidemiol Rev 2011;33:20-35.
29. Ministerio de Sanidad y Política Social. Documento marco sobre cribado poblacional. Diciembre de 2010. Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/prevPromocion/documentomarcoCribado.htm.
30. Terrault NA, Pawlotsky JM, McHutchison J, Anderson F, Krajden M, Gordon S, et al. Clinical utility of viral load measurements in individuals with chronic hepatitis C infection on antiviral therapy. J Viral Hepat 2005;12:465-72.
31. Berenguer J. Elimination of hepatitis C virus in Spain: A pending challenge. Enferm Infecc Microbiol Clin 2018;36:323-4.
32. Backus LI, Belperio PS, Shahoumian TA, Loomis TP, Mole LA. Real-world effectiveness and predictors of sustained virological response with all-oral therapy in 21,242 hepatitis C genotype-1 patients. Antivir Ther 2017;22:481-93.
33. Smith-Palmer J, Cerri K, Valentine W. Achieving sustained virologic response in hepatitis C: Systematic review of the clinical, economic and quality of life benefits. BMC Infect Dis 2015;15:19.
34. Pellicoro A, Ramachandran P, Iredale JP, Fallowfield JA. Liver fibrosis and repair: Immune regulation of wound healing in a solid organ. Nat Rev Immunol 2014;14:181-94.
35. Van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA 2012;308:2584-93.
36. Morgan TR, Ghany MG, Kim HY, Snow KK, Shiffman ML, de Santo JL, et al. HALT-C Trial Group. Outcome of sustained virological responders with histologically advanced chronic hepatitis C. Hepatology 2010;52:833-44.
37. Coretti S, Romano F, Orlando V, Codella P, Prete S, di Brino E, et al. Economic evaluation of screening programs for hepatitis C virus infection: Evidence from literature. Risk Manag Healthc Policy 2015;8:45-54.
38. Coward S, Leggett L, Kaplan GG, Clement F. Cost-effectiveness of screening for hepatitis C virus: A systematic review of economic evaluations. BMJ Open 2016;6:e011821.
39. Midgard H, Weir A, Palmateer N, lo Re V3rd, Pineda JA, Macías J, et al. HCV epidemiology in high-risk groups and the risk of reinfection. J Hepatol 2016;65(1 Suppl):S33-45.
40. Crespo J, Lázaro de Mercado P, Blasco Bravo AJ, Aguilera GA, García-Samaniego RJ, Eiros Bouza JM, et al. Diagnosis of hepatitis C virus infection in Spain: An opportunity to improve. Enferm Infecc Microbiol Clin 2019;37:231-8.
41. Cabezas J, Vázquez IF, Llerena S, Carrión JA, Moya AG, Lens S, et al. FRI-225-Universal access to direct-acting antivirals treatment is not not enough to prevent late stage presentation of hepatitis C infection. J Hepatol 2019;70:e493-4.
42. Hill AM, Khan A, Nath A, Simmons K. ‘‘Diagnostic Burn-out’’ for hepatitis C: When will countries run out of diagnosed people to treat with DAAs? Hepatology 2017;66(Suppl 1):149-185. http://dx.doi.org/10.1002/hep.29501.
43. Hill A, Simmons B. The road to elimination of Hepatitis C: Analysis of SVR versus new HCV infections in 91 countries. Disponible en: http://www.natap.org/2017/AASLD/ AASLDNetCure%20Oct21X.pdf.
44. Buti M, Calleja JL, García-Samaniego J, Serra MA, Crespo J, Romero M, et al. Elimination of hepatitis C in Spain: Adaptation of a mathematical model based on the public health strategic plan for addressing hepatitis C in the National Health System. Med Clin (Barc) 2017;148:277-82.
45. Terrault NA, Dodge JL, Murphy EL, Tavis JE, Kiss A, Levin TR, et al. Sexual transmission of hepatitis C virus among monogamous heterosexual couples: The HCV partners study. Hepatology 2013;57:881-9.
46. Benova L, Mohamoud YA, Calvert C, Abu-Raddad LJ. Vertical transmission of hepatitis C virus: Systematic review and metaanalysis. Clin Infect Dis 2014;59:765-73.
47. Lazarus JV, Bromberg DJ, del Amo AJ, Norgaard O, García Samaniego J, Casellas A, et al. Hepatitis C prevalence among the migrant population in Spain: A systematic review and metaanalysis. Enferm Infecc Microbiol Clin 2019;37:222-30.
48. Alarcón-Linares E, Torres-Cantero A, Subirá C, Ramírez Rubio O, Crespo J, Lazarus JV, et al. Geographic analysis and estimation of hepatitis C cases in migrant populations living in Spain: Is a country-based screening strategy appropriate? Rev Esp Enferm Dig 2019;111:615-25.
49. Greenaway C, Makarenko I, Chakra CNA, Alabdulkarim B, Christensen R, Palayew A, et al. The effectiveness and cost-effectiveness of hepatitis C screening for migrants in the EU/EEA: A systematic review. Int J Environ Res Public Health 2018;15:pii:E2013.
50. Morales-Arráez D, Alonso-Larruga A, Díaz-Flores F, García Dopico JA, de Vera A, Quintero E, et al. Predictive factors for not undergoing RNA testing in patients found to have hepatitis C serology and impact of an automatic alert. J Viral Hepat 2019. http://dx.doi.org/10.1111/jvh.13122.
51. Martínez-Crespo E. Search for ANTI-hepatitis C virus positive patients lost in the health system: Analysis of the absence of referring and the abandonment of the patients. Hepatology 2018;68(Suppl 1):928A-9A.
52. Cimavilla M, Garrido-López S, Almohalla C, García-Pajares F, Torres-Yuste R, Peñas-Herrero I, et al. Is an active search program for HCV useful to increase the rate of treatment? Hepatology 66(Suppl);397A.
53. Sánchez Antolín G, Sañudo S, Jiménez T, Blanco Ledo AM, Martín Sobrino N, García Vela JM. Hepatitis C: un ejemplo de planificación estratégica desde un área sanitaria. En: XXI Congreso Nacional de Hospitales y Gestión Sanitaria. Santiago de Compostela, 8-10 de mayo; 2019.
54. Lazarus JV, Safreed-Harmon K, Thursz MR, Dillon JF, el-Sayed MH, Elsharkawy AM, et al. The micro-elimination approach to eliminating hepatitis C: Strategic and operational considerations. Semin Liver Dis 2018;38:181-92.
55. Cuadrado A, Llerena S, Cobo C, Pallas JR, Mateo M, Cabezas J, et al. Microenvironment eradication of hepatitis C: A novel treatment paradigm. Am J Gastroenterol 2018;113:1639-1648.
56. Llerena S, Mateo M, Cobo C, Cabezas J, Cuadrado A, Blasco AJ, et al. Eficiencia de un programa de telemedicina en el manejo de la hepatitis C en población reclusa [póster]. Gastroenterol Hepatol 2019.
57. Jiménez-Galán G, Alia-Alia C, Vegue-González M, García-Berriguete RM, Fernández-González F, Fernández-Rodríguez C, et al. The contribution of telemedicine to hepatitis C elimination in a correctional facility. Rev Esp Enferm Dig 2019;111:550-5.
58. Crespo J, Eiros Bouza JM, Blasco Bravo AJ, Lazaro de MP, Aguilera GA, García F, et al. The efficiency of several onestep testing strategies for the diagnosis of hepatitis C. Rev Esp Enferm Dig 2019;111:10-6.
59. Assoumou SA, Tasillo A, Leff JA, Schackman BR, Drainoni ML, Horsburgh CR, et al. Cost-effectiveness of one-time hepatitis C screening strategies among adolescents and young adults in primary care settings. Clin Infect Dis 2018;66:376-84.
60. Chevaliez S, Pawlotsky JM. New virological tools for screening, diagnosis and monitoring of hepatitis B and C in resource-limited settings. J Hepatol 2018;69:916-26.
61. Corma-Gómez A, Pineda JA. Hepatitis C virus infection in Spain: Challenges in the track to elimination. Enferm Infecc Microbiol Clin 2019;37:219-21.
62. Sharafi H, Poustchi H, Azimian F, Tamadoni B, Ramezani R, Gouya MM, et al. Performance of a rapid diagnostic test for screening of hepatitis C in a real life prison setting. J Clin Virol 2019;113:20-3.
63. Diagnóstico microbiológico en el lugar de asistencia del paciente. Disponible en: https://seimc.org/contenidos/documentoscientificos/procedimientosmicrobiologia/seimcprocedimientomicrobiologia66.pdf.
64. Vázquez-Moron S, Ardizone JB, Jiménez-Sousa MA, Bellon JM, Ryan P, Resino S. Evaluation of the diagnostic accuracy of laboratory-based screening for hepatitis C in dried blood spot samples: A systematic review and meta-analysis. Sci Rep 2019;9:7316.
65. Muzembo BA, Mbendi NC, Nakayama SF. Systematic review with meta-analysis: Performance of dried blood spots for hepatitis C antibodies detection. Public Health 2017;153:128-36.
Related articles

Editorial

Cases of liver disease lost in the health system: a call to action

DOI: 10.17235/reed.2021.8316/2021

Original

Active search for hepatitis C patients in primary care

DOI: 10.17235/reed.2021.8067/2021

Original

Hepatitis C in homeless people: reaching a hard-to-reach population

DOI: 10.17235/reed.2021.7737/2020

Editorial

Screening guide for hepatitis C virus infection in Spain

DOI: 10.17235/reed.2020.7728/2020

Review

New non-invasive biomarkers for colorectal cancer screening

DOI: 10.17235/reed.2020.7233/2020

Special Article

Strategy for the Elimination of Hepatitis C in Cantabria

DOI: 10.17235/reed.2020.7108/2020

Editorial

Reflex testing. A key tool for the elimination of hepatitis C

DOI: 10.17235/reed.2020.7201/2020

Original

Quality of life study in asymptomatic patients with hepatitis C

DOI: 10.17235/reed.2019.6339/2019

Letter

Acute seronegative hepatitis C: two case reports

DOI: 10.17235/reed.2019.5921/2018

Editorial

Colorectal cancer screening and survival

DOI: 10.17235/reed.2018.5870/2018

Letter

Why anal cytology is not enough in a dysplasia screening program

DOI: 10.17235/reed.2018.5678/2018

Citation tools
Crespo J, Albillos A, Buti M, Calleja J, García Samaniego J, Hernández Guerra M, et all. Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH). 6700/2019


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 2143 visits.
This article has been downloaded 844 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Accepted: 24/10/2019

Online First: 28/10/2019

Published: 07/11/2019


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology