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Using the Diabetes Care System for a County-Wide Hepatitis C Elimination: An Integrated Community-Based Shared Care
Tsung-Hui Hu1, Dih-Ling Luh2,3, Yo-Yu Tsao4
1Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
The American Journal of Gastroenterology
|December 12, 2023
Summary
A shared care model successfully integrated hepatitis C virus (HCV) screening and treatment into diabetes care for patients with diabetes (PwD). This approach significantly reduced viremic HCV infection prevalence by nearly 70% in Taiwan.
Area of Science:
- Hepatology
- Public Health
- Primary Care Medicine
Background:
- Diabetes and hepatitis C virus (HCV) co-infection presents significant health risks.
- HCV elimination strategies often overlook patients with diabetes (PwD).
- Primary care settings offer a potential venue for integrated HCV care.
Purpose of the Study:
- To evaluate a shared care model for HCV elimination in patients with diabetes.
- To assess the feasibility and effectiveness of integrating HCV services into primary diabetes care.
- To improve HCV care continuum indicators among PwD.
Main Methods:
- A prospective study involving 27 community-based Diabetes Health Promotion Institutes in Changhua, Taiwan (January 2018-December 2020).
- Integration of HCV screening and treatment into structured diabetes care.
- Collaboration between diabetes and HCV care teams.
Main Results:
- High HCV screening uptake (93.4%) among 10,684 eligible PwD, with a 6.18% seroprevalence.
- Successful HCV treatment completion in 86.5% of viremic patients, achieving a 79.4% cure rate.
- Viremic HCV infection prevalence decreased by 69.70% after antiviral treatment.
Conclusions:
- A shared care model effectively enhances HCV testing and treatment in patients with diabetes.
- Consistent HCV care cascade results were observed across different locations.
- This integrated model demonstrates successful HCV elimination potential within primary care settings.
