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A hiddenly high hepatitis C virus related liver disease burden among Chinese patients with non-liver disease complaints: A hospital based study from 2013 to 2017
Hua-Ping Huang1, Guo-Sheng Yuan2, Yu-Chen Zhou3, Cheng-Guang Hu2, Jun-Wei Liu2, Shuai Yuan4, Yu-Rong Qiu4, Yi-Ping Li5, Yong-Yuan Zhang6, Yuan-Ping Zhou2
1 Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou; Department of Respiratory Diseases, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
2 Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangzhou, China
3 Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
4 Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China
5 Institute of Human Virology and Key Laboratory of Tropical Disease Control of Ministry of Education, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
6 HBVtech, Germantown, Maryland, MD 20874, USA
Correspondence Address:
Yong-Yuan Zhang
HBVtech, Germantown, Maryland, MD 20874
USA
Yuan-Ping Zhou
Professor of Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, 1838 North Guangzhou Avenue, Guangzhou 510515
China
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/1995-7645.225028
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Objective: To determine the frequency of anti-HCV antibody positivity in patients with non-liver disease complaints, to explore whether anti-HCV positive patients had been properly advised and visited hepatologists for further assessments, and to investigate their clinical characteristics as well as the HCV treatment status. Methods: A hospital based survey of non-liver disease patients with anti-HCV positive and their attending physicians was conducted to determine: 1. were the patients adequately advised of the implication of anti-HCV positive finding; 2. to what extent the patients were aware of potential chronic liver disease associated with HCV infection and whether they sought for further assessments and care of hepatologists. Results: A total of 295 294 non-liver disease patients were tested for anti-HCV antibody, and 2 778 of them were found to be positive (0.94%). However, only 45.10% (1 253/2 778) of the anti-HCV antibody (+) patients were referred to hepatologists and received HCV RNA test. In addition, 34.10% (312/915) and 1.42% (13/915) of them had already advanced to cirrhosis and hepatocellular carcinoma (HCC), respectively. Further analysis showed that the patients who declined antiviral therapy were older, with lower education and lower income, possessed poorer knowledge on the risk of chronic hepatitis C, and had more severe liver diseases. Surprisingly, 65% of the surveyed physicians did not know the genotype-guided treatment duration suggested by the guidelines. Alarmingly, 22% of the surveyed physicians did not know the standard assays for the diagnosis of HCV infection. Conclusions: Our findings highlight the challenge and hidden enormous burden of chronic HCV infection among patients with non-liver disease complaints in China.
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