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Retrieval of lost patients in the system for hepatitis C microelimination: a single-center retrospective study
Hsu-Heng Yen1,2,3, Pei-Yuan Su4, I-L Ing Liu4
1Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, No. 135 Nanhsiao Street, Changhua, Taiwan. 91646@cch.org.tw.
Insights
A hospital-based Hepatitis C virus (HCV) callback campaign successfully re-engaged patients lost to follow-up. This initiative effectively identified active infections and facilitated treatment, supporting HCV microelimination efforts.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Hepatitis C virus (HCV) is a primary cause of chronic liver disease, cirrhosis, and liver cancer, often asymptomatic.
- Current HCV elimination strategies rely on testing and treatment.
- Identifying and re-engaging patients lost to follow-up is crucial for effective disease management.
Purpose of the Study:
- To evaluate the effectiveness of a patient callback campaign for retrieving individuals lost to follow-up for Hepatitis C virus (HCV) re-evaluation.
- To assess the feasibility of a targeted approach for HCV microelimination within a hospital setting.
Main Methods:
- A hospital-based callback campaign was conducted from January 2020 to October 2020.
- Patients with positive anti-HCV antibody results from 2010-2018, with unknown HCV RNA status or no documented therapy, were targeted.
- An electronic reminding system and telephone calls were used to re-engage patients for HCV RNA testing and therapy evaluation.
Main Results:
- 3783 patients with positive anti-HCV antibody were identified; 2337 were eligible after exclusions.
- 1472 (62.99%) eligible patients were successfully contacted and recalled.
- Among recalled patients, 42.19% tested positive for HCV RNA, and 88% initiated subsequent anti-HCV therapy.
Conclusions:
- A substantial proportion of patients with positive HCV serology were lost to confirmatory testing or treatment.
- The targeted HCV callback approach proved feasible and effective for patient re-engagement and treatment.
- This strategy contributes to achieving microelimination goals for Hepatitis C virus.
Background:
Hepatitis C virus (HCV) is one of the major causes of chronic liver disease, cirrhosis, and liver cancer. Most of the infected people have no clinical symptoms. The current strategy for HCV elimination includes test and treatment. In this study, we aimed to evaluate the campaign for retrieving patients who were lost to follow-up, for subsequent re-evaluation.
Methods:
From January 2020 to October 2020, patients who had prior tests for positive anti-HCV antibody in 2010-2018 in our hospital were enrolled for our patient callback campaign. Patients who had unknown HCV RNA status or no documented successful antiviral therapy history were selected for anti-HCV therapy re-evaluation. To facilitate patient referral in the hospital, we developed an electronic reminding system and called the candidate patients via telephone during the study period.
Results:
Through the hospital electronic system, 3783 patients with positive anti-HCV antibody documentation were identified. Among them, 1446 (38.22%) had tested negative for HCV RNA or had anti-HCV therapy, thereby excluded. Of the 2337 eligible patients, 1472 (62.99%) were successfully contacted and called back during the study period for subsequent HCV RNA testing and therapy. We found that 42.19% of the patients had positive HCV RNA and 88% received subsequent anti-HCV therapy.
Conclusions:
A significant number of patients with positive HCV serology were lost for HCV confirmatory test or therapy in the hospital. Therefore, this targeted HCV callback approach in the hospital is feasible and effective in achieving microelimination.
