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                <title level="j">Liver International</title>
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                  <publisher>Wiley-Blackwell</publisher>
                  <biblScope unit="pp">Online ahead of print</biblScope>
                  <date type="datePub">2021-09-18</date>
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              <idno type="doi">10.1111/liv.15056</idno>
              <idno type="pubmed">34520614</idno>
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                <term xml:lang="en">diabetes mellitus</term>
                <term xml:lang="en">hazardous alcohol use</term>
                <term xml:lang="en">hepatitis C</term>
                <term xml:lang="en">severe liver fibrosis</term>
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              <p>Background and aims: Late presentation for care of hepatitis C virus (HCV) infection - defined as having severe liver fibrosis when first consulting a specialist for HCV care - increases morbidity and mortality. Identifying the socio-behavioural correlates of late presentation is essential to improve HCV strategies to optimize HCV cascade of care. We investigated clinical and socio-behavioural correlates of late presentation for care in HCV mono-infected individuals.Methods: This study included chronic HCV mono-infected patients participating in the French national cohort ANRS CO22 HEPATHER, starting in 2012. The correlates of late presentation were estimated using a Heckman probit selection model, which takes into account the possible selection bias because of missing data in the outcome.Results: Among the 9174 study patients, 1236 had available data on liver fibrosis stage at first presentation for HCV care. Of these, 591 (47.8%) were late presenters. In a multivariable analysis adjusted for age, sex and HCV genotype, having diabetes (adjusted coefficient [95% confidence interval]: 0.55 [0.30; 0.80]), current hazardous alcohol use (0.36 [0.03; 0.69]) and current abstinence but past hazardous alcohol use (0.42 [0.19; 0.64]) (vs. current abstinence and no past hazardous use) were all independently associated with late presentation for HCV care.Conclusions: As late presentation severely affects HCV cascade of care, our findings bring important new evidence about the need to promptly identify and target people with diabetes and/or past or current hazardous alcohol use for HCV screening and treatment within the wider context of the WHO goal to eliminate HCV by 2030.</p>
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