Researchers from the Incliva Health Research Institute have started a project to detect the possibility of infection by the hepatitis C virus (HCV) in the population not studied for liver disease in order to be able to offer them treatment and prevent the progression of liver disease in them.

Likewise, it is intended to discover possible viral infections of other types of hepatitis (HBV and HDV) and caused by other viruses –such as the human immunodeficiency virus (HIV) that causes acquired immunodeficiency syndrome (AIDS)– that share mechanisms of HCV transmission in the study population to be able to refer, if necessary, to the relevant services for monitoring and treatment.

The project ‘Impact of the implementation of new screening strategies for microelimination of hepatitis C in the Department of Health of Valencia Clínico-Malvarrosa’ has as principal investigators doctors Amparo Escudero – from the Incliva Neurological Impairment Research Group, specialist in Digestive Medicine of the Department of Health Valencia-Malvarrosa Clinic and professor of the Department of Medicine of the University of Valencia (UV)-, whose lines of research include the study of viral liver diseases, and David Navarro -coordinator of the Research Group in Molecular Microbiology and Microbial Pathogenesis of Incliva, head of the Microbiology and Parasitology Service of the Clinical Hospital and professor of Microbiology at the UV-.

Hepatitis C – explain those responsible for the investigation – is the only chronic viral infection that is completely cured by eliminating the virus, but it is also a global public health problem. According to the latest published data, it affects more than 70 million people in the world, which represents 1% of the population.

In addition, recent studies carried out in Spain during the last 3 years estimate that the seroprevalence (percentage of people who have come into contact with the virus) of anti-hepatitis C virus (HCV) ranges between 0.8% and 1 0.2% of the adult population and that between 0.2% and 0.4% show an active HCV infection and, therefore, are at risk of developing liver cirrhosis and associated complications in the medium-long term to her. An important part of these people have already been diagnosed and treated, although there is a relatively high number of patients -especially those over 50 years of age- who are unaware that they have hepatitis C.

The undiagnosed fraction of HCV infection is 29.4% for active infection, placing the number of people with active infection who are unaware of being infected at 22,478 people in our country. In addition to people with active infection who are unaware that they are infected, we must also add patients who, despite being diagnosed, are not being treated.

The seroprevalence of HCV infection in the population that attends the emergency room is clearly higher than that estimated in the general population, with an active infection rate twice as high, so hepatitis C screening in the emergency services can be an effective strategy to increase the diagnosis rate of HCV infection, they add.

To improve not only the diagnosis of HCV infection, but also to achieve a better treatment rate in those diagnosed, it is important to improve the care circuits for these patients. In this sense, “one-step diagnosis” manages to avoid the loss of patients in the system, which can be attributed to the high number of medical visits until the start of treatment.

Based on these data from studies in emergency services and taking into account both the objective of the World Health Organization (WHO) for HCV and the screening recommendations of the Spanish Association for the Study of the Liver (AEEH), which suggest that the entire population should have an HCV determination at some point in their lives, the action in this project is aimed at the population treated in the Emergency Service and to those who undergo the pertinent preoperative period in the Anesthesia Service, taking advantage of the time of obtaining an analysis.

The study is being carried out with the participation of the Digestive Medicine, Emergency, Anesthesia and Microbiology services of the Hospital Clínico de València.

The research team is made up of doctors Rafael Badenes and Carlos Tornero, from the INCLIVA Anesthesiology and Resuscitation Research Group and from the Anesthesia and Resuscitation Service of the Clinical Hospital; José Javier Noceda and Mª Teresa Sánchez, from the Medical Emergency Service of the Hospital Clínico; Mª Jesús Alcaraz, from the INCLIVA Molecular Microbiology and Microbial Pathogenesis Research Group and the Hospital Clínico Microbiology Service; David Martí Aguado, Joan Rodés researcher at Incliva and the Digestive Medicine Service of the Hospital Clínico; and Mª Pilar Ballester Farré, from the Incliva Neurological Impairment Research Group and the Digestive Medicine Service of the Clinical Hospital.

The current project, with a duration of 24 months (18 months for the recruitment period and 6 months for final analysis), has obtained funding of 23,594.32 euros in the 5th Call for GILEAD Scholarships for hepatitis C microelimination projects. and epidemiology in hepatitis D 2022, aimed at competitive projects, which are awarded after study and evaluation of AEEH.