Algorithm for early diagnosis of viral hepatitis C

Abstract Issue Viral hepatitis C (VH C) is a global problem of the public health. Different interventions for achieving the Global Health Sector Strategy on viral hepatitis targets (65% reduction in HCV-related deaths, 90% in new infections and 90% of infections diagnosed by 2030) were considered. Increased diagnosis and treatment rates would be required to achieve these targets in all countries, even with the introduction of high sustained viral response therapies. Description of the problem The latest global HCV disease burden estimates showed that about 71.1 million people worldwide are viremic, corresponding to a prevalence of 1%. The prevalence of HCV is not homogenous: the WHO Eastern-Mediterranean Region is with the highest number of infected subjects (15 millions), followed by the European Region (14 million). In Bulgaria, the incidence of VH C is 0.63-1.30 at 100 000 population (2008-2020) and in Pleven region is 0.38-3.8, respectively. Results Retrospective study was conducted upon epidemiological, demographic, clinical, laboratory and viral characteristics in fifty cases of VH C confirmed with positive anti-HCV, evaluated by ELISA. Thirty eight of cases were hospitalized in different clinics of the University Hospital “Dr Georgi Stranski”-Pleven (2017-2018) and remainders were blood-donors registered in Regional Center of Transfusion Hematology-Pleven. Surgical interventions (26.32%), blood infusions (23.68%) and hemodialysis (15.79%) were at highest risk for VH C. Twenty five hospital patients were with chronic VH C (66%), five with cirrhosis (13%) and eight (21%) with acute hepatitis C. Twenty of the patients (53%) were asymptomatic about hepatitis and were hospitalized because of different comorbidities (p < 0.0005). Lessons We propose an algorithm for early diagnosis of VH C based on mandatory screening for anti-HCV in risk groups, especially before invasive procedures. The early detection of HCV infection will reduce the complications and nosocomial infections. Key messages • Different scenarios developed to achieve the WHO Targets in all countries assume an implementation of national policies to prevent new infections and to diagnose current infections through screening. • The early detection of HCV infection will reduce the complications and nosocomial infections.

Issue: Viral hepatitis C (VH C) is a global problem of the public health. Different interventions for achieving the Global Health Sector Strategy on viral hepatitis targets (65% reduction in HCV-related deaths, 90% in new infections and 90% of infections diagnosed by 2030) were considered. Increased diagnosis and treatment rates would be required to achieve these targets in all countries, even with the introduction of high sustained viral response therapies. Description of the problem: The latest global HCV disease burden estimates showed that about 71.1 million people worldwide are viremic, corresponding to a prevalence of 1%. The prevalence of HCV is not homogenous: the WHO Eastern-Mediterranean Region is with the highest number of infected subjects (15 millions), followed by the European Region (14 million). In Bulgaria, the incidence of VH C is 0.63-1.30 at 100 000 population (2008-2020) and in Pleven region is 0.38-3.8, respectively.

Results:
Retrospective study was conducted upon epidemiological, demographic, clinical, laboratory and viral characteristics in fifty cases of VH C confirmed with positive anti-HCV, evaluated by ELISA. Thirty eight of cases were hospitalized in different clinics of the University Hospital ''Dr Georgi Stranski' '-Pleven (2017'-Pleven ( -2018 and remainders were blooddonors registered in Regional Center of Transfusion Hematology-Pleven. Surgical interventions (26.32%), blood infusions (23.68%) and hemodialysis (15.79%) were at highest risk for VH C. Twenty five hospital patients were with chronic VH C (66%), five with cirrhosis (13%) and eight (21%) with acute hepatitis C. Twenty of the patients (53%) were asymptomatic about hepatitis and were hospitalized because of different comorbidities (p < 0.0005).

Lessons:
We propose an algorithm for early diagnosis of VH C based on mandatory screening for anti-HCV in risk groups, especially before invasive procedures. The early detection of HCV infection will reduce the complications and nosocomial infections.

Key messages:
Different scenarios developed to achieve the WHO Targets in all countries assume an implementation of national policies to prevent new infections and to diagnose current infections through screening. The early detection of HCV infection will reduce the complications and nosocomial infections.

Introduction:
As the proportion of older people increases, it is necessary to evaluate their health and well-being to identify measures to promote healthy ageing. Moreover, the COVID-19 pandemic has impacted older adults' health-not just through the infection itself, but also due to infection protection ordinances. Methods: LAB60+ is a population-based cross-sectional study investigating, among other things, the physical and mental health of older adults. Residents of Dresden aged 60 years and older were invited to participate in the first half of 2021. Participants answered questions on their habits, health status and wellbeing, using, among others, the Short Form-8 Health Survey and the WHO wellbeing index.
Results: 2399 people participated in the study (40% response). Participants assessed their physical health similar to the German population. The most common chronic conditions were hypertension (54%), chronic pain (32%) and osteoarthritis (31%). 42% of the participants were overweight and 20% were obese. One-fifth did not engage in physical activity: this number increased with age and decreased socioeconomic status. Participants reported lower levels of wellbeing compared to the German population (58 vs. 67 pts.). One-third had higher levels of depressiveness and half reported an increase in their experienced loneliness due to the pandemic. 34% participated in risky alcohol consumption, but it did not markedly change during the pandemic. The greatest negative impact of the pandemic on health behaviors was physical