A Global Systematic Review of Hepatitis C Elimination Efforts through Micro-Elimination.

Microelimination targets specific subpopulations and/or geographic settings for hepatitis C virus (HCV) elimination. This review reports on global HCV microelimination literature published from 2013 to 2020. Data were extracted from publications to report a score based on the four key components defining microelimination. Sustained virologic response (SVR) and treatment initiation proportions were calculated for each manuscript and grouped means of these estimates were compared depending on microelimination score and care setting. A total of 83% of the studies were from high-income settings and mainly included people who use drugs or those incarcerated. Among manuscripts, 18 had "low" microelimination scores, 11 had "high" scores, and the differences in mean proportion who initiated treatment and achieved SVR between low and high score groups were statistically significant. Microelimination can be a useful complementary strategy for driving engagement in HCV treatment and cure. Our analysis suggests that adhering to more of the core microelimination components can improve outcomes. This study is registered with Prospero, registration identification: CRD42020175211.

Thieme. All rights reserved.

J.V.L. reports grants, personal fees, and other from AbbVie and Gilead Sciences; personal fees from CEPHEID, GSK, Genfit, Intercept, and Janssen; and grants and personal fees from MSD, outside the submitted work. J.C. reports grants from Gilead, Abbvie, and Intercept, outside the submitted work. M.C. reports personal fees from Intercept, Exelyxis, and Target HCC; and other from COST, outside the submitted work. G.C. reports grants from Gilead, Abbvie, Merck, and Bristol-Myers Squibb; personal fees from Gilead, Abbvie, and Merck; and nonfinancial support from Gilead, Abbvie, and Merck, outside the submitted work. J.G. reports grants and personal fees from Abbvie, Gilead Sciences, Merck, and Cepheid; and grants from Hologic and Indivior, outside the submitted work. J.W.W. reports grants from Gilead Sciences, AbbVie, Abbott, Cepheid, Merck, Roche, Siemens, Pharco, Zydus Cadila, nongovernmental organizations, professional associations, the United States government, and individuals, outside the submitted work. J.F.D. reports grants and other from Gilead, MSD, Abbvie, and Astra Zeneca; and grants from Cephid, outside the submitted work. C.A.P., C.B., and G.J.D. have nothing to disclose.