Associated screening for HCV and SARS-Cov2 infection in an urban area of Southern Italy: the “Casola di Napoli” cohort study

Introduction: The spread of SARS-Cov2 pandemic led to a substantial reorganization of all the non-related and non-urgent clinical activities in Italy, with a subsequent reduction of the available resources for the management of other potentially curable diseases. This is the case of the HCV infection that, in Italy, had recently seen important milestones towards its elimination which, now, risk being nullified. On the other hand, one of the biggest questions regarding the epidemiology of COVID-19 is the real burden of the asymptomatic carriers. It would be very useful to associate the screening for both the diseases, in order to effectively respond to two important clinical needs. Methods: A prospective observational cohort study was set-up in an urban area of the Naples province, in which a contemporary screening for HCVAb and for SARS-Cov-2 IgG/IgM rapid blood tests was performed. All the positive patients underwent RT-PCR for HCVRNA and/or SARS-Cov-2-RNA. The study was approved by our Ethical Committee. Results: Of the 3845 people who live and work in the chosen area, 3556 were eligible for the screening and, of these, 2740 (77.05%) participated voluntarily from June 25 to July 12, 2020. Of them, 39 patients(1.4%) resulted SARS-Cov2-IgM- or -IgG-positive. None of these resulted subsequently positive for SARS-Cov2-RNA. Forty-one patients were HCVAb-positive(1.5%) and, of them, 5(0.18%) resulted HCVRNA-positive. Of those HCVAb positive, 36/41(87.8%) reported awareness of their positivity and, in 88.8% of cases(32/36), had already been subjected to antiviral therapy with a 96.87%(31/32)SVR. Of the other 4 patients aware of their positivity, 2(50%) were HCVRNA-positive. Of the remaining 5 HCVAb-positive patients, that were unaware of their positivity, 2 were HCVRNA-positive. Of notice, HCVAb-positivity was detected in patients of >41 years with 82.0%(32/39) in the 61-80 years age-class. Conclusions: The screening of an entire cohort of an urban area of Southern Italy showed a seroprevalence of anti-SARS-Cov2-Ab and HCV-Ab of 1.4% and 1.5%, respectively, whereas only 0.18% had an active HCV infection. This study shows how the pandemic can be an opportunity to promote prevention activities for HCV.