Demonstration of a population-based HCV serosurvey in Ho Chi Minh City, Viet Nam: Establishing baseline prevalence of and continuum of care for HCV micro-elimination by 2030

Background A baseline of hepatitis C virus (HCV) burden and other HCV epidemiological profiles is necessary for HCV micro-elimination in Ho Chi Minh City (HCMC), Viet Nam. This study aimed to determine HCV exposure and prevalence of HCV viremia as well as the proportion of HCV testing and treatment uptake among participants. Methods From 2019 to 2020, the probability proportionate to size sampling method was deployed to representatively invite approximately 20,000 adults (18 or older) throughout HCMC to free screening and linkage to care for HCV. Findings In HCMC, the weighted prevalence of anti-HCV was 1.3% (95% CI, 1.1%-1.6%). Individuals born from 1945 to 1964 had the anti-HCV prevalence of 3.6% (95% CI, 3.0%-4.2%) and represented 40.4% of all HCV cases. There were wide variations in anti-HCV prevalence in HCMC, including variations between districts, risk factors, and socioeconomic statuses. A baseline HCV continuum of care for the city demonstrated that only 28.5% (85/298, 95%CI 23.4-33.7%) of persons with anti-HCV (+) were aware of their HCV status, with 77.6% (66/85, 95%CI 68.8-86.5%) diagnosing HCV incidentally, 82.7% (62/75, 95%CI 74.1-91.2%) initiating anti-HCV therapy, and 53.6% (30/56, 95%CI 40.5-66.6%) achieving HCV cures. Interpretation There remains a considerable disease burden of HCV in HCMC of which a significant proportion was in the age group born between 1945 to 1964. Additionally, there were significant gaps in HCV awareness, screening, and access to care in the community in Viet Nam. Thus, future interventions must have pragmatic tar-gets, be tailored to the local needs, and emphasise screening. Funding This work was supported by investigator-sponsored research grants from Gilead Sciences Inc. (Grant No: IN-US-987-5382); Roche Diagnostic International Ltd. (Grant No. SUB-000196); and in-kind donations from Abbott Diagnostic Viet Nam; Hepatitis B Foundation; Medic Medical Center, Viet Nam; Johns Hopkins University School of Medicine's Center of Excellence for Liver Disease in Viet Nam; and the Board of Directors, Viet Nam Viral Hepati-tis Alliance (V-VHA). Copyright (C) 2022 The Authors. Published by Elsevier Ltd.

Automated summary

The study reveals a high burden of hepatitis C virus (HCV) exposure and prevalence in Ho Chi Minh City, particularly among individuals born between 1945 and 1964. There are significant gaps in HCV awareness, screening, and access to care in the community. Future interventions should be tailored to local needs and emphasize screening.