Hepatitis C Screening: Barriers to Linkage to Care

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis C (HCV) poses a significant public health challenge requiring effective management strategies.
• While HCV screening is available, substantial barriers impede patient assessment and treatment initiation.
• Linkage to care is a critical, yet often interrupted, step in the HCV treatment pathway.

Purpose of the Study:

• To evaluate the linkage to care process for patients screened for Hepatitis C (HCV) within a healthcare system.
• To identify demographic and clinical factors associated with successful linkage to HCV specialist care.
• To determine the proportion of viremic HCV patients who were not referred for specialist treatment.

Main Methods:

• Retrospective analysis of patients screened for HCV antibodies between February and July 2018.
• Defined linkage to care as confirmatory RNA testing and specialist appointment scheduling.
• Collected demographic data and baseline laboratory values to assess factors influencing care linkage.

Main Results:

• Out of 17,512 individuals screened, 238 (1.35%) had positive HCV antibodies.
• Of 190 with further testing, 70 were viremic, but 17 (24%) were not linked to a specialist.
• Younger patients and individuals who inject drugs were significantly less likely to be referred for specialty care (p=0.02).

Conclusions:

• Younger individuals and people who inject drugs represent vulnerable populations with lower rates of referral for HCV treatment.
• Healthcare systems must develop targeted strategies to overcome barriers and improve care linkage for these at-risk groups.
• Enhanced engagement efforts are necessary to ensure equitable access to Hepatitis C treatment and reduce viral transmission.