Generalized implementation of reflex testing of hepatitis C in Galicia: Results for reflection

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Active Hepatitis C Virus (HCV) infection diagnosis and referral for treatment are critical public health objectives.
• Previous referral rates for HCV therapeutic evaluation were suboptimal.
• Reflex testing and informative alerts were implemented to improve patient management.

Purpose of the Study:

• To evaluate the impact of implementing reflex testing for active HCV infection in the Galician Health Service (SERGAS).
• To characterize newly diagnosed active HCV infections identified through reflex testing.
• To assess referral rates for therapeutic evaluation and treatment outcomes.

Main Methods:

• Retrospective analysis of data from microbiology services in SERGAS hospitals since 2018.
• Identification and characterization of patients with newly diagnosed active HCV infection via reflex testing.
• Review of referral patterns, diagnostic triggers (viral load), HCV genotypes, treatment initiation, and sustained viral response (SVR).

Main Results:

• In 2018, 258 patients with unknown active HCV infection were identified; 70.2% were male, with a median age of 52.
• Referral for therapeutic evaluation was achieved in 81.0% of cases, with a median of 54 days from diagnosis.
• HCV viral load triggered reflex testing in 58.3% of cases; genotype 1a was predominant (30.7%). Of those treated (52.1%), 93.7% achieved sustained viral response.

Conclusions:

• Generalized implementation of HCV reflex testing and informative alerts in Galicia has led to referral rates comparable to other studies.
• The study highlights a need for improvements, such as enhanced training and optimization strategies, due to observed variability between healthcare centers.
• Reflex testing is an effective strategy for identifying and managing active HCV infections, contributing to improved treatment outcomes.