{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T12:06:10Z","timestamp":1784549170050,"version":"3.55.0"},"reference-count":44,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>Abstract: Hepatitis C virus infection remains a leading cause of chronic liver disease worldwide, affecting more than 70 million people, many of whom remain undiagnosed or untreated. In Brazil, Rio Grande do Sul State has the highest hepatitis C detection rate, underscoring the need for coordinated strategies to eliminate it by 2030. Underdiagnosis and barriers to treatment initiation persist despite the availability of highly effective antiviral therapies. This study aimed to estimate the proportion of diagnosed individuals who initiated treatment and to find factors associated with non-initiation of treatment. A retrospective cohort included all hepatitis C cases that had been diagnosed in 2022-2023 and reported in the Brazilian Information System for Notifiable Diseases (SINAN). Treatment initiation was verified in the Logistics Control System for Medications for Viral Hepatitis (SICLOM-HV). Probabilistic record linkage was performed to integrate both databases and to assess factors associated with non-initiation of treatment. Among 2,671 diagnosed individuals, 64.9% started treatment, with a median of 104 days between diagnosis and initiation. Multivariable analysis showed lower initiation among Black individuals than in White ones (adjusted OR = 1.41; 95%CI: 1.02-1.93) and among those aged 0-39 than in those aged 50-59 years (adjusted OR = 0.68; 95%CI: 0.49-0.96). Regional differences, HIV coinfection, and clinical variables also affected initiation. Treatment coverage in Rio Grande do Sul State remains below elimination targets. Persistent disparities by race, region, and coinfection highlight the need for targeted strategies to ensure equitable hepatitis C care and accelerate elimination efforts.<\/jats:p>","DOI":"10.1590\/0102-311xen233025","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:23:03Z","timestamp":1784546583000},"source":"Crossref","is-referenced-by-count":0,"title":["Factors influencing hepatitis C treatment initiation in a high-prevalence Brazilian state"],"prefix":"10.1590","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7169-7409","authenticated-orcid":false,"given":"Vit\u00f3ria Machado","family":"Kr\u00fcger","sequence":"first","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2528-1180","authenticated-orcid":false,"given":"Ana Carolina Almeida da","family":"Silva","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5412-7405","authenticated-orcid":false,"given":"Marlise Antunes","family":"Grahl","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4750-2043","authenticated-orcid":false,"given":"Matheus dos Anjos","family":"Catasblancas","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2286-2933","authenticated-orcid":false,"given":"Maiara Lenise","family":"L\u00fctz","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7187-2036","authenticated-orcid":false,"given":"Jo\u00e3o Pedro Stepan","family":"Wagner","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0122-0244","authenticated-orcid":false,"given":"Alexandre Lemos da","family":"Silva","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil; Universidade Federal de Santa Maria,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6347-6431","authenticated-orcid":false,"given":"Eduardo Viegas da","family":"Silva","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-448X","authenticated-orcid":false,"given":"Pedro Augusto Crespo da","family":"Silva","sequence":"additional","affiliation":[{"name":"Secretaria da Sa\u00fade do Rio Grande do Sul,  Brasil; Universidade Federal de Santa Maria,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1111\/liv.14011","article-title":"Hepatitis C is eradication possible?","volume":"39","author":"Lombardi A","year":"2019","journal-title":"Liver Int"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"101502","DOI":"10.1016\/j.clinre.2021.101626","article-title":"HCV virology and diagnosis","volume":"45","author":"Roger S","year":"2021","journal-title":"Clin Res Hepatol 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C","volume":"22","author":"Gonz\u00e1lez-Grande R","year":"2016","journal-title":"World J Gastroenterol"},{"key":"ref8","first-page":"2035","article-title":"Chronic hepatitis C virus infection an ongoing challenge in screening and treatment","volume":"13","author":"Tsai WC","year":"2023","journal-title":"Life (Basel)"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1080\/13814788.2022.2056161","article-title":"Chronic hepatitis C diagnosis and treatment made easy","volume":"28","author":"Abu-Freha N","year":"2022","journal-title":"Eur J Gen Pract"},{"key":"ref10","series-title":"Protocolo cl\u00ednico e diretrizes terap\u00eauticas para hepatite C e coinfec\u00e7\u00f5es","year":"2019"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"3249","DOI":"10.3748\/wjg.v27.i23.3249","article-title":"Update on the management and treatment of viral hepatitis","volume":"27","author":"Almeida PH","year":"2021","journal-title":"World J 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hepatitis C treatment: focus on overcoming barriers","year":"2023"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.4254\/wjh.v16.i8.1091","article-title":"Bridging the gap addressing disparities in hepatitis C screening, access to care, and treatment outcomes","volume":"16","author":"Alenzi M","year":"2024","journal-title":"World J Hepatol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1590\/S0034-8910.2014048005388","article-title":"Socioeconomic inequalities in access to and quality of health care services","volume":"48","author":"Nunes BP","year":"2014","journal-title":"Rev Sa\u00fade P\u00fablica"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1590\/1413-81232022272.03052021","article-title":"Socioeconomic inequalities in access to health services a population-based study in Southern Brazil","volume":"27","author":"Wendt A","year":"2022","journal-title":"Ci\u00eanc Sa\u00fade 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F","year":"2016","journal-title":"Clin Infect Dis"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1186\/s12913-025-13527-6","article-title":"Racial inequalities in access to healthcare services in Brazil","volume":"25","author":"Coelho R","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1007\/s11606-019-05394-9","article-title":"Medication non-adherence in a prospective, multi-center cohort treated with hepatitis C direct-acting antivirals","volume":"35","author":"Serper M","year":"2020","journal-title":"J Gen Intern Med"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1093\/cid\/ciad034","article-title":"Perspectives on adherence from the ACTG 5360 MINMON trial a minimum monitoring approach with 12 weeks of sofosbuvir\/velpatasvir in chronic hepatitis C treatment","volume":"76","author":"Sowah LA","year":"2023","journal-title":"Clin Infect Dis"},{"key":"ref38","article-title":"Analysis of access to health services in Brazil according to sociodemographic profile National Health Survey, 2019","volume":"31","author":"Palmeira NC","year":"2022","journal-title":"Epidemiol Serv Sa\u00fade"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1111\/jgh.15228","article-title":"Barriers to hepatitis C direct-acting antiviral therapy among HIV\/HCV-coinfected persons","volume":"36","author":"Jatt LP","year":"2021","journal-title":"J Gastroenterol Hepatol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"4491","DOI":"10.12998\/wjcc.v9.i18.4491","article-title":"Current treatment for hepatitis C virus\/human immunodeficiency virus coinfection","volume":"9","author":"Laiwatthanapaisan R","year":"2021","journal-title":"World J Clin Cases"},{"key":"ref41","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003284","article-title":"Barriers to and impacts of hepatitis C treatment among people who inject drugs in Kenya","volume":"5","author":"Manley HN","year":"2025","journal-title":"PLOS Glob Public Health"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"103306","DOI":"10.1016\/j.drugpo.2021.103354","article-title":"Drug use stigma and hepatitis C virus infection among people who inject drugs","volume":"96","author":"Patel EU","year":"2021","journal-title":"Int J Drug Policy"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1055\/s-0038-1666841","article-title":"The micro-elimination approach to eliminating hepatitis C","volume":"38","author":"Lazarus JV","year":"2018","journal-title":"Semin Liver Dis"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"4777","DOI":"10.1590\/S1413-81232011001300026","article-title":"Barriers faced by drug users seeking hepatitis treatment in Brazil","volume":"16","author":"Malta M","year":"2011","journal-title":"Ci\u00eanc Sa\u00fade Colet"}],"container-title":["Cadernos de Sa\u00fade P\u00fablica"],"original-title":["Fatores que influenciam o in\u00edcio do tratamento da hepatite C em um estado brasileiro de alta preval\u00eancia"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0102-311X2026000105063&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:23:09Z","timestamp":1784546589000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-311X2026000105063&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":44,"alternative-id":["S0102-311X2026000105063"],"URL":"https:\/\/doi.org\/10.1590\/0102-311xen233025","relation":{},"ISSN":["1678-4464","0102-311X"],"issn-type":[{"value":"1678-4464","type":"electronic"},{"value":"0102-311X","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e00233025"}}