Brazil's Fight Against Hepatitis C: Surveillance, Control, and Care / RP

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    Persistently high hepatitis C rates in haemodialysis patients in Brazil [a systematic review and meta‑analysis]
    (2022) Niquini, Roberta Pereira; Mota, Jurema Corrêa da; Bastos, Leonardo Soares; Barbosa, Diego da Costa Moreira; Falcão, Juliane da Silva; Palmieri, Paloma; Martins, Patrícia; Villar, Livia Melo; Bastos, Francisco I.
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    Recentralizing drug procurement in a context of decentralized heal system: the case os hepatitis C drugs in Brazil
    (2022) Arantes, Luísa Bolaffi; Davidian, Andreza; Fonseca, Elize Massard da; Shadlen, Ken
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    Performance of HCV Antigen Testing for the Diagnosis and Monitoring of Antiviral Treatment: A Systematic Review and Meta-Analysis
    (2022) Flores, Geane Lopes; Mota, Jurema Corrêa da; Andrade, Larissa Tropiano da Silva; Lopes, Renata Serrano; Bastos, Francisco Inácio; Villar, Livia Melo
    Background and Aims. Active hepatitis C virus (HCV) infection is based on the detection of HCV RNA that it is effective but presents high cost and the need to hire trained personnel. This systematic review and meta-analysis is aimed at evaluating the diagnostic accuracy of HCV Ag testing to identify HCV cases and to monitor antiviral treatment including DAA treatment. Methods. The studies were identified through a search in PubMed, Lilacs, and Scopus from 1990 through March 31, 2020. Cohort, cross-sectional, and randomized controlled trials were included. Two independent reviewers extracted data and assessed quality using an adapted Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Our primary outcome was to determine the accuracy of HCV Ag detection for the diagnosis, which we estimated using random-effects meta-analysis. Results. Of 3,062 articles identified, 54 met our eligibility criteria. The studies described cohorts from 20 countries, including 14,286 individuals with chronic HCV individuals. Studies for ECLIA technology demonstrated highest quality compared to studies that used ELISA. The pooled sensitivity and specificity (95% CI) for HCV Ag detection of active HCV infection were 98.82% (95%CI = 98:04%; 99.30%) and 98.95% (95%CI = 97:84%; 99.49%), respectively. High concordance was found between HCV Ag testing and HCV RNA detection 89.7% and 95% to evaluate antiviral treatment. Conclusions. According to our findings, HCV Ag testing could be useful to identify HCV active cases in low-resource areas. For antiviral treatment, HCV Ag testing will be useful at the end of treatment.
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    Nota técnica Hepatite C no Brasil: panorama atual e desafios em face à pandemia de COVID-19
    (2021-03-11) Coutinho, Carolina; Bastos, Francisco Inácio; Fonseca, Elize Massard da; Shadlen, Ken
    Essa nota técnica tem por objetivo apresentar uma análise descritiva de dados oficiais sobre hepatite C a fim de elaborar um panorama e subsidiar cenários epidemiológicos deste agravo no Brasil. Além disso, essa nota contextualiza as ações de diagnóstico e tratamento do HCV em relação às metas estabelecidas no plano para eliminação das hepatites virais, bem como as alterações na assistência ao paciente de hepatite C em função da epidemia de COVID-19.