RT Journal Article
SR Electronic
T1 Establishment of an outreach, grouping healthcare system to achieve microelimination of HCV for uremic patients in haemodialysis centres (ERASE-C)
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP gutjnl-2020-323277
DO 10.1136/gutjnl-2020-323277
A1 Ming-Lung Yu
A1 Chung-Feng Huang
A1 Yu-Ju Wei
A1 Wen-Yi Lin
A1 Yi-Hung Lin
A1 Po-Yao Hsu
A1 Cheng-Ting Hsu
A1 Ta Wei Liu
A1 Jia-Jung Lee
A1 Sheng-Wen Niu
A1 Jiun-Chi Huang
A1 Tzu-Sui Hung
A1 Ming-Lun Yeh
A1 Ching-I Huang
A1 Po-Cheng Liang
A1 Ming-Yen Hsieh
A1 Szu-Chia Chen
A1 Jee-Fu Huang
A1 Jer-Ming Chang
A1 Yi-Wen Chiu
A1 Chia-Yen Dai
A1 Shang-Jyh Hwang
A1 Wan-Long Chuang
A1 ,
YR 2020
UL http://gut.bmj.com/content/early/2020/12/21/gutjnl-2020-323277.abstract
AB Objective HCV prevails in uremic haemodialysis patients. The current study aimed to achieve HCV microelimination in haemodialysis centres through a comprehensive outreach programme.Design The ERASE-C Campaign is an outreach programme for the screening, diagnosis and group treatment of HCV encompassing 2323 uremic patients and 353 medical staff members from 18 haemodialysis centres. HCV-viremic subjects were linked to care for directly acting antiviral therapy or received on-site sofosbuvir/velpatasvir therapy. The objectives were HCV microelimination (>80% reduction of the HCV-viremic rate 24 weeks after the end of the campaign in centres with ≥90% of the HCV-viremic patients treated) and ‘No-C HD’ (no HCV-viremic subjects at the end of follow-up).Results At the preinterventional screening, 178 (7.7%) uremic patients and 2 (0.6%) staff members were HCV-viremic. Among them, 146 (83.9%) uremic patients received anti-HCV therapy (41 link-to-care; 105 on-site sofosbuvir/velpatasvir). The rates of sustained virological response (SVR12, undetectable HCV RNA 12 weeks after the end of treatment) in the full analysis set and per-protocol population were 89.5% (94/105) and 100% (86/86), respectively, in the on-site treatment group, which were comparable with the rates of 92.7% (38/41) and 100% (38/38), respectively, in the link-to-care group. Eventually, the HCV-viremic rate decreased to 0.9% (18/1,953), yielding an 88.3% reduction from baseline. HCV microelimination and ‘No-C HD’ were achieved in 92.3% (12/13) and 38.9% (7/18) of the haemodialysis centres, respectively.Conclusion Outreach strategies with mass screenings and on-site group treatment greatly facilitated HCV microelimination in the haemodialysis population.ClinicalTrials.gov identifier NCT03803410 and NCT03891550