AIM: Aim of the pilot was to increase HIV/HCV/syphilis testing and linkage to care of newly diagnosed persons, improve data collection and transfer using standard data collection tools in CBVCT services. METHODS: Integrated anonymous voluntary testing from blood for HIV, HCV and syphilis was realised using rapid tests in the period of 6 months (03/2019-08/2019). Participants with reactive results were advised to see a specialist for confirmatory testing and/or treatment. RESULTS: A total of 675 clients were tested for HIV, 410 for HCV, and 457 for syphilis. Participants' median age ranged from 24 to 35.6 (IQR: 24), 75.3% of them were men, 23.7% were women, and 0.6% identified as transgender. In terms of groups at risk 48.9 % of 675 clients were men who have sex with men (MSM), 0.3 % sex workers (SW), 9.0 % people who inject drugs (PWID), 2.4 % migrants (Mi) and the rest of clients (8.3 %) belonged to groups at combined risk. Pilot revealed HIV, HCV and T. pallidum infections in 0.4 %, 2.4 % and 1.8 % of clients, respectively. Just 2 clients, confirmed HIV-positive, were linked to care. The highest prevalence of HIV (4.2 %), HCV (30.8 %) and syphilis (7.1 %) was found among MSM/Mi, PWID and SW/PWID, respectively. Condomless intercourse with SW, PWID, MSM and HIV-positive person in the last 12 months was reported by 5/92, 41/82, 3/78 and 0/88 of responding clients, respectively. Core indicators were included in the yearly national epidemiological report. CONCLUSIONS: Pilot revealed the need to support integrated CBVCT to overcome barriers in confirmatory testing and linkage to care and to integrate core data of monitoring and evaluation (M&E) testing framework at CBVCT services into a national surveillance and M&E systems in Slovakia.

• Klíčová slova
• HCV, HIV, Slovakia, Syphilis, integrated testing, secular trends,
• MeSH
• dospělí MeSH
• hepatitida C * diagnóza   epidemiologie   MeSH
• HIV infekce * diagnóza   epidemiologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• pilotní projekty MeSH
• plošný screening metody   MeSH
• poradenství MeSH
• syfilis * diagnóza   epidemiologie   MeSH
• testování na HIV metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH

The global effort to eliminate HCV infection requires new approaches to accessing and testing the affected population in a setting with as low of a threshold as possible. The focus should be on socially marginalized people who inject drugs (PWIDs) and who are not willing or able to visit standard medical services. With this vision, we established an outreach service-a testing point in an ambulance in the park in front of the Main Railway Station of the capital city of Prague-to provide bloodborne disease testing and treatment. The service was available every week on Wednesday afternoon. Over the initial two years of our experience, 168 unique people were tested. Of them, 82 (49%) were diagnosed with chronic HCV infection and were eligible for treatment with antivirals. Of these, 24 (29%) initiated antiviral treatment over the study period, and 17 (71%) of these individuals achieved a documented sustained virological response. Offering medical services in PWIDs' neighborhoods helps overcome barriers and increase the chances that they will become patients and begin HCV treatment. The described outcomes appear promising for reaching the vision of linkage to the care of such a hard-to-reach population and can serve as a feasible model of care for further expansion.

• Klíčová slova
• Comprehensive Care Program (CCP), HCV infection, Prague, WHO HCV elimination plan, off-site service, outreach program Remedis, people who inject drugs (PWIDs), viral hepatitis C,
• MeSH
• antivirové látky terapeutické užití   MeSH
• Hepacivirus MeSH
• hepatitida C * farmakoterapie   epidemiologie   prevence a kontrola   MeSH
• intravenózní abúzus drog * epidemiologie   MeSH
• lidé MeSH
• uživatelé drog * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antivirové látky MeSH

The aim of this paper is to introduce the digitalization process and its effects on better reach of the target population. Progress in the digitalization and e-health tools worldwide enables new opportunities in prevention, diagnostics and treatment for people living with HIV (PLHIV) and people in the risk of HIV infection, hepatitis C (HCV) and other sexually transmitted infections (STIs), especially in the context of the COVID-19 pandemic. The system already used for voluntary counselling and testing (VCT) at the CheckPoint Centre Zagreb run by the non-governmental organization (NGO) Croatian Association for HIV and Viral Hepatitis (CAHIV) was upgraded and adapted (due to the COVID-19 prevention epidemiological measures) and developed for implementation of the pilot project of feasibility and acceptability of home HIV self-testing (HIVST) among men who have sex with men (MSM) in Zagreb. A special feature of the HIVST mobile application enables an innovative approach in collecting clients' test result feedback. This paper presents the method of use digitalization of the VCT and HIVST activities to support and increase availability of screening testing. Described procedures of new technologies application in VCT services and preliminary results of the HIVST pilot project indicate that technology-delivered interventions can contribute and improve access and utilisation of HIV/STI prevention and care services.

• Klíčová slova
• HIV, digital technology, sexual behaviour, sexually transmitted diseases, testing, voluntary counselling and testing,
• MeSH
• COVID-19 * MeSH
• digitální technologie MeSH
• Hepacivirus MeSH
• hepatitida C * diagnóza   epidemiologie   prevence a kontrola   MeSH
• HIV infekce * diagnóza   epidemiologie   prevence a kontrola   MeSH
• homosexualita mužská MeSH
• lidé MeSH
• pandemie MeSH
• pilotní projekty MeSH
• poradenství MeSH
• sexuálně přenosné nemoci * diagnóza   epidemiologie   prevence a kontrola   MeSH
• sexuální a genderové menšiny * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Chorvatsko epidemiologie   MeSH

The elimination of HCV (hepatitis C virus) infection is, according to WHO (World Health Organization), of international interest. With new diagnostic tools and treatment possibilities, one major challenge for the elimination is to involve infected patients, especially those from socially excluded subpopulations, into HCV infection-treatment programs. The key question is how to help people who inject drugs (PWID) to engage in HCV infection-treatment programs and improve communication between PWID and hepatologists or other medical professionals involved in the treatment of chronic HCV infection. Furthermore, the medical professionals have to accept the changing spectrum of patients with chronic viral hepatitis. Without close interdisciplinary cooperation, it would be extremely difficult to achieve the WHO goal of global viral hepatitis C elimination. Here, we try to encourage our colleagues as well as addictologists and social workers to play their crucial part in the viral hepatitis C eradication process. It is extremely important for the healthcare providers to be able to communicate with addicted clients, inform PWID about the latest developments in the diagnosis and HCV infection treatment, and get them motivated to engage with specialized treatment programs.

• Klíčová slova
• HCV, HCV infection, PWID, WHO, global HCV elimination plan, hepatitis C virus, people who inject drugs, viral hepatitis C,
• MeSH
• antivirové látky terapeutické užití   MeSH
• Hepacivirus MeSH
• hepatitida C * diagnóza   epidemiologie   prevence a kontrola   MeSH
• intravenózní abúzus drog * komplikace   farmakoterapie   epidemiologie   MeSH
• lidé MeSH
• Světová zdravotnická organizace MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antivirové látky MeSH

OBJECTIVES: The aim of the study is to analyse drug-related infectious diseases (DRID) rates for people who inject drugs (PWID) in the Pilsen Region in order to identify the main determiners of infection risk and also to provide a foundation for comparison between this region and the others in the Czech Republic. METHODS: In a descriptive cross-sectional study, we analysed the Pilsen Region's data on PWID. The data was transcribed from the 2003 to 2018 internal database of the Ulice Outreach Programme. In addition to the data regarding the testing of DRID, we analysed commercial sex work (CSW) and the PWID's duration of drug use, age and current address. The statistical analysis was performed using SPSS, primarily employing logistic regression (i.e., backward elimination method) to explore predictors of seropositivity. Moreover, we calculated its prevalence from an epidemiological perspective. RESULTS: In total, 384 PWID were tested, from which 54.7% were males, and 84.1% were from Pilsen. The average age for initiation of using drug was 19.37 years. The most used drug was methamphetamine (64.8%), 77 women (20.1%) were reported to be CSW. The prevalence of DRID was as follows: hepatitis C virus (HCV) 37.24%, syphilis 1.82%, hepatitis B virus (HBV) 0.78%, and HIV infection 0.26%. The analysis showed that men had a lower risk of syphilis than women. Individuals who started their drug use via injection had a 1.365-times higher risk of DRID in comparison to those who initiated intravenous drug use later in their drug-using lives. We identified a significant association between the drug type and the risk of HCV infection: the main predictor of seropositivity was the use of fentanyl, which posed a 1.930-times higher risk than in the case of methamphetamine. CONCLUSIONS: This study is the first descriptive cross-sectional study implemented in the Pilsen Region in the Czech Republic with a focus on the subpopulation of PWID with individual data. A high prevalence of HCV infection still persists but the prevalence of HBV and HIV infections in this study (and generally in the Czech Republic) is relatively low compared to foreign studies. Syphilis is not closely associated with injecting-drug use, but rather with the sexual behaviour of the people who use drugs intravenously. The most important predictor of seropositivity for syphilis was CSW. We also found the duration of being a CSW to be significant influence. The women who had been CSWs for less than 5 years had a significantly lower risk of syphilis than those who had prostituted for more than 5 years.

• Klíčová slova
• Czech Republic, Pilsen Region, commercial sex workers, drug-related infectious diseases, people who inject drugs,
• MeSH
• dospělí MeSH
• Hepacivirus MeSH
• hepatitida C * epidemiologie   MeSH
• HIV infekce * epidemiologie   MeSH
• intravenózní abúzus drog * epidemiologie   MeSH
• lidé MeSH
• methamfetamin * MeSH
• mladý dospělý MeSH
• prevalence MeSH
• prostituce MeSH
• průřezové studie MeSH
• riskování MeSH
• syfilis * epidemiologie   MeSH
• uživatelé drog * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• methamfetamin * MeSH

BACKGROUND: Following the introduction of direct-acting antiviral therapy in 2013, WHO launched the first Global Health Sector Strategy on Viral Hepatitis. We describe a hepatitis C virus (HCV) cascade of care in people with HIV (PWH) across Europe in terms of reaching the WHO elimination targets of diagnosing 90% and treating 80% of HCV-infected individuals. METHODS: HIV/HCV-coinfected participants in the EuroSIDA cohort under prospective follow-up at October 1, 2019, were described using a nine-stage cascade of care. Care cascades were constructed across Europe, on a regional (n = 5) and country (n = 21) level. RESULTS: Of 4773 anti-HCV positive PWH, 4446 [93.1%, 95% confidence interval (CI) 92.4-93.9)] were ever tested for HCV RNA, and 19.0% (95% CI 16.4-21.6) were currently HCV RNA positive, with the highest prevalence in Eastern and Central-Eastern Europe (33.7 and 29.6%, respectively). In Eastern Europe, 78.1% of the estimated number of chronic infections have been diagnosed, whereas this proportion was above 95% in the other four regions. Overall, 3116 persons have ever started treatment (72.5% of the ever chronically infected, 95% CI 70.9-74.0) and 2404 individuals (55.9% of the ever chronically infected, 95% CI 53.9-57.9) were cured. Cure proportion ranged from 11.2% in Belarus to 87.2% in Austria. CONCLUSION: In all regions except Eastern Europe, more than 90% of the study participants have been tested for HCV-RNA. In Southern and Central-Western regions, more than 80% ever chronically HCV-infected PWH received treatment. The proportion with cured HCV infection did not exceed 80% in any region, with significant heterogeneity between countries. SUMMARY: In a pan-European cohort of PWH, all regions except Eastern Europe achieved the WHO target of diagnosing 90% of chronic HCV infections, while the target of treating 80% of eligible persons was achieved in none of the five regions.

• MeSH
• antivirové látky terapeutické užití   MeSH
• chronická hepatitida C * komplikace   farmakoterapie   epidemiologie   MeSH
• Hepacivirus genetika   MeSH
• hepatitida C * komplikace   farmakoterapie   epidemiologie   MeSH
• HIV infekce * komplikace   farmakoterapie   epidemiologie   MeSH
• koinfekce * farmakoterapie   MeSH
• lidé MeSH
• prospektivní studie MeSH
• RNA terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• antivirové látky MeSH
• RNA MeSH

In 2016, the WHO announced a plan to eliminate viral hepatitis as a public health threat by 2030. In this narrative review, experts from Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland and Slovakia assessed the feasibility of achieving the WHO 2030 target for HCV infections in Central Europe. They focused mainly on HCV micro-elimination in prisons, where the highest incidence of HCV infections is usually observed, and the impact of the COVID-19 pandemic on the detection and treatment of HCV infections. According to the presented estimates, almost 400,000 people remain infected with HCV in the analyzed countries. Interferon-free therapies are available ad libitum, but the number of patients treated annually in the last two years has halved compared to 2017-2019, mainly due to the COVID-19 pandemic. None of the countries analyzed had implemented a national HCV screening program or a prison screening program. The main reason is a lack of will at governmental and prison levels. None of the countries analyzed see any chance of meeting the WHO targets for removing viral hepatitis from the public threat list by 2030, unless barriers such as a lack of political will and a lack of screening programs are removed quickly.

• Klíčová slova
• HCV, WHO, epidemiology, hepatitis, screening, therapy,
• MeSH
• COVID-19 * epidemiologie   prevence a kontrola   MeSH
• hepatitida C * diagnóza   epidemiologie   prevence a kontrola   MeSH
• lidé MeSH
• pandemie prevence a kontrola   MeSH
• věznice MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH

INTRODUCTION: hepatitis C is a public health problem worldwide, in particular in sub-Saharan Africa. The purpose of this study is to determine the seroprevalence of hepatitis C virus antibodies and associated factors during a voluntary general population screening program in Benin. METHOD: we conducted a descriptive and analytical cross-sectional study in 4 big cities of 4 different departments in Benin in July 2016. All volunteers of all ages, residing in these targeted cities, who gave their informed consent were included in the study. ImuMed HCV Rapid Diagnostic Test (Healgen Scientific LLC, USA) was used. Logistic regression analysis was also used to identify factors associated with hepatitis C virus infection. RESULTS: a total of 2809 volunteers with an average age of 25.9 ± 16.5 years (ranging from 0 to 86 years) were included in the study; 53.9% (1514/2809) of them were men and 46.1% (1295/2809) were women. More than half of the study population consisted of single (59.1%; 1612/2726); 41.3% (1074/2809) were pupils or students. VHC Seroprevalence was 1.5% (42/2809). In multivariate analysis, the variables significantly associated with anti-HCV carriage were: be 60 years old and older (aOR: 46.9, 95% CI 10.2-216.0; p<0.0001) and a history of alcoholism (aOR: 6.3; 95% CI 95% 3.3-12.1; p < 0.0001). CONCLUSION: in the general population, the seroprevalence of anti-HCV antibodies was 1.5%. HCV infection mainly occurred in people aged 60 years and older and in those with a history of alcoholism.

INTRODUCTION: l´hépatite C est un problème de santé publique dans le monde, et plus particulièrement en Afrique subsaharienne. L´objectif de ce travail était de déterminer la séroprévalence des anticorps anti-virus de l´hépatite C ainsi que les facteurs associés, à l´occasion d´un dépistage volontaire en population générale au Bénin. MÉTHODES: il s´agissait d´une étude transversale descriptive et analytique qui s´était déroulée en juillet 2016 dans 4 grandes villes de 4 différents départements du Bénin. Etaient inclus tous les volontaires résidents dans ces villes ciblées, de tous âges, ayant donné leur consentement éclairé. Pour cette recherche, le test de diagnostic rapide HCV ImuMed (Healgen Scientific LLC, USA) avait été utilisé. Une analyse par régression logistique avait été utilisée afin d´identifier les facteurs associés à l´infection par le virus de l´hépatite C. RÉSULTATS: au total, 2809 volontaires étaient inclus avec une moyenne d´âge de 25,9± 16,5 ans (les extrêmes: 0 et 86 ans), constitués de 53,9% (1514/2809) d´hommes et de 46,1% (1295/2809) de femmes. Plus de la moitié de la population d´étude était constituée de célibataires 59,1% (1612/2726). Il s´agissait principalement de 41,3% (1074/2809) d´élèves ou étudiants. La séroprévalence du VHC était de 1,5% (42/2809). En analyse multivariée, les variables significativement associées au portage des anti-VHC étaient: l´âge de 60 ans et plus (aOR: 46,9, IC 95% 10,2-216,0; p < 0,0001) et l´antécédent d´alcoolisme (aOR: 6,3, IC 95% 3,3-12,1; p < 0,0001). CONCLUSION: la séroprévalence des anticorps anti-VHC était de 1,5% dans la population étudiée. L´infection par le VHC touchait volontiers les sujets âgés (de 60 ans et plus) et ceux ayant un antécédent d´alcoolisme.

• Klíčová slova
• Benin, Hepatitis C virus, associated factors, prevalence,
• MeSH
• alkoholismus epidemiologie   MeSH
• dítě MeSH
• dospělí MeSH
• hepatitida C - protilátky krev   MeSH
• hepatitida C diagnóza   epidemiologie   MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• plošný screening metody   MeSH
• předškolní dítě MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• séroepidemiologické studie MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Benin epidemiologie   MeSH
• Názvy látek
• hepatitida C - protilátky MeSH

Hepatitis C virus (HCV) infection is still a major cause of chronic liver diseases, with approximately 71 million chronically infected persons worldwide. People who inject drugs currently or in the past (PWID), mostly intravenously, are the main risk group among HCV chronically infected persons. The efficacy of therapy with direct-acting antivirals (DAA) is almost 100 %. Currently, the main mission is to diagnose HCV infection in the most possible number of infected persons; it is in collision with poor adherence of PWID in particular. Changing the spectrum of chronic hepatitis C patients forces medical professionals to change their approach to diagnosis and treatment of HCV infection. Outreach testing and cooperation with support organizations showed to be an effective way to set a course to eliminate HCV in the PWID population.

• Klíčová slova
• HCV elimination, chronic hepatitis C, outreach screening,
• MeSH
• antivirové látky terapeutické užití   MeSH
• časná diagnóza MeSH
• chronická hepatitida C * farmakoterapie   MeSH
• Hepacivirus MeSH
• hepatitida C * diagnóza   farmakoterapie   epidemiologie   MeSH
• intravenózní abúzus drog * farmakoterapie   epidemiologie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antivirové látky MeSH

According to the recent data presented by Central-European HCV experts, the estimated prevalence of HCV is between 0.2% and 1.7% in certain countries in this region. There are no financial limitations to access to treatment in most countries. Patients in these countries have access to at least one pangenotypic regimen. The most common barriers to the elimination of HCV in Central Europe are a lack of established national screening programmes and limited political commitment to the elimination of HCV. Covid-19 has significantly affected the number of patients who have been diagnosed and treated, thus, delaying the potential elimination of HCV. These data suggest that the elimination of HCV elimination projected by WHO before 2030 will not be possible in the Central Europe.

• Klíčová slova
• epidemiology, hepatitis C virus, liver, therapy,
• MeSH
• antivirové látky terapeutické užití   MeSH
• COVID-19 * MeSH
• hepatitida C * diagnóza   farmakoterapie   epidemiologie   MeSH
• lidé MeSH
• prevalence MeSH
• SARS-CoV-2 MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• antivirové látky MeSH