Active search for hepatitis C patients in primary care
Lucía Seoane Blanco1, Javier Soto Sánchez2, Gema Sierra Dorado3
1Aparato Digestivo, Hospital Universitario San Agustín, España.
Insights
Active searching for hepatitis C virus (HCV) in primary care, combined with one-step diagnosis (OSD), effectively identifies hidden infections and increases treatment completion, aiding HCV elimination efforts.
Area of Science:
- Hepatology
- Public Health
- Infectious Diseases
Background:
- Undiagnosed active hepatitis C virus (HCV) infections hinder the World Health Organization's 2030 elimination goal.
- Primary care (PC) offers a strategic setting for active patient identification and case finding.
Purpose of the Study:
- To evaluate the effectiveness of an active search strategy in primary care for identifying and treating patients with undiagnosed hepatitis C.
- To assess the utility of the one-step diagnosis (OSD) approach in confirming active HCV infections.
Main Methods:
- Retrospective review of primary care patient records with an "hepatitis C" open case over five years.
- Inclusion of cases with incomplete diagnostic workups or those not initiated/completed treatment.
- Implementation of one-step diagnosis (OSD) for viremia assessment in patients with new serologic diagnoses.
Main Results:
- Out of 253 cases, 24.1% had incomplete diagnostics or treatment.
- Of 57 eligible patients, 92.9% accepted diagnostic testing.
- Active infections were confirmed in 75.4% (40 patients), with 100% treatment completion.
Conclusions:
- Active case finding in primary care is crucial for detecting undiagnosed hepatitis C.
- The one-step diagnosis (OSD) method facilitates rapid confirmation of active infections.
- Combined strategies significantly increase treatment rates, contributing to hepatitis C elimination goals.
Introduction:
undiagnosed active hepatitis C virus (HCV) infections are an obstacle to achieve the WHO (World Health Organization) hepatitis C elimination goal by 2030. One of the possible strategies to identify these patients is the active search for patients in primary care (PC).
Methods:
patient medical records in PC were reviewed with a "hepatitis C" open case in the last five years. Cases with an incomplete diagnostic study (due to the absence of active infection confirmation) or those who did not start or finish treatment were included. A blood analysis was recommended to prove the existence of an active infection. The one-step diagnosis (OSD) was implemented to assess viremia in all patients with a new serologic diagnosis.
Results:
of 253 cases with a "hepatitis C" open case in their medical records, 24.1 % (61) did not finish the diagnostic study or did not follow the treatment. Four were not suitable candidates to finish the study. Of the other 57, 92.9 % accepted the diagnostic test. Active infections were confirmed in 40 patients (75.4 %) and the treatment was completed in all of them.
Conclusions:
active searching for patients with hepatitis C in PC together with the OSD are effective measures to detect hidden infections and to increase the number of treatments, thus contributing to the elimination of hepatitis C.
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