Authors
Patrícia Ferreira Abreu, Pablo Rodrigues Costa Alves, Paulo Lisboa Bittencourt, Isadora Cartaxo de Sousa Calvo, Osvaldo Merege Vieira Neto, Marcelo Mazza do Nascimento, Felipe Costa Neves, Ana Flavia Moura, Daniel Costa Chalabi Calazans, Juan Miguel Villalobos Salcedo, Cristina Melo Rocha, Cirley Maria de Oliveira Lobato, Alex Vianey Callado França, Alessandra Maria Mont'Alverne Pierre, Adalgisa de Souza Paiva Ferreira, Edmundo Pessoa Lopes, Jose Eymard Moraes de Medeiros Filho, Francisco José Dutra Souto, Rodrigo Sebba Aires, Liliana Sampaio Costa Mendes, Silvia Naomi de Oliveira Uehara, Luciana Lofego Gonçalves, Lilian Pires de Freitas do Carmo, Cláudia Alexandra Pontes Ivantes, Hugo Cheinquer, Tatiara Bueno Parreira, Karla Cristina Silva Petruccelli Israel, Verônica de Jesus Rodrigues Cardozo Costa, Hivis da Costa Sousa, Jarinne Camilo Landim Nasserala, Kleyton de Andrade Bastos, Maria Eliete Pinheiro, Artur Quintiliano Bezerra da Silva, Claudia Maria Costa de Oliveira, Flávio Henrique Soares Barros, Marclébio Manuel Coêlho Dourado, Ciro Bruno Costa, Ricardo Araújo Mothé, Alexandre Silvestre Cabral, Denise Rodrigues Simão, Fellype de Carvalho Barreto, Paulo Henrique Fraxino, Natasha Silva Constancio, Dirceu Reis da Silva, Álvaro Pacheco Silva Filho, Lúcio Roberto Requião Moura, David Jose de Barros Machado, Alexandre Minetto Brabo, Alice Pignaton Naseri, Tomás Ribeiro Carvalho, Nathalia da Fonseca Pestana, Pedro Tulio Monteiro de Castro E Abreu Rocha, Leila Maria Soares Tojal de Barros Lima, Renata M Perez, Janaina Luz Narciso-Schiavon, Antônio Ricardo Cardia Ferraz de Andrade, Bruno Zawadzki, José A Moura-Neto, Maria Lucia Gomes Ferraz
Published in
Jornal brasileiro de nefrologia. Volume 48. Issue 4. Pages e20260092.
Abstract
Hepatitis C virus (HCV) infection remains a major public health challenge, particularly among patients undergoing dialysis, who are disproportionately vulnerable and at increased risk of transmission. Micro-elimination strategies targeting high-risk subpopulations are a critical component for achieving the World Health Organization global HCV elimination goals.
This national, multicenter, prospective implementation study was conducted within the framework of the Brazilian Registry for the Elimination of HCV in Dialysis Units. All 904 active dialysis units in the country were invited; 384 (42.5%) joined voluntarily, and, within each, all eligible patients were enrolled (census) between 2021 and 2024. The HCV cascade of care was evaluated, including serological screening (anti-HCV), virological confirmation (HCV-RNA), treatment with direct-acting antivirals (DAAs), and assessment of sustained virologic response (SVR).
A total of 66,601 patients were evaluated, yielding a national anti-HCV prevalence of 2.08%. HCV-RNA testing coverage reached 65.4%, with a positivity rate of 64.2% among those tested, resulting in an adjusted prevalence of active viremia of 1.34%. Among patients with detectable viremia, 74.2% initiated antiviral therapy, 92.6% completed treatment, and 93.3% achieved SVR. The main barriers identified along the cascade of care included limited availability of diagnostic tests and patient mortality.
These findings indicate that Brazil has achieved robust therapeutic effectiveness indicators, placing the country at an advanced stage toward HCV elimination within the dialysis population. Nonetheless, important operational gaps persist, particularly in diagnostic confirmation.
Elimination of HCV in dialysis units is an achievable goal in Brazil. Sustained success depends on maintaining universal screening, ensuring prompt treatment initiation for confirmed cases, and strengthening continuous integration between services.
PMID:
42743380
Bibliographic data and abstract were imported from PubMed on 16 Sep 2026.
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