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Missed Opportunities: A Retrospective Study of Hepatitis C Testing in Hospital Inpatients

Christine Roder1,2, Carl Cosgrave3, Kathryn Mackie4,5

  • 1Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia.

Viruses
|June 27, 2024
PubMed

Insights

Hepatitis C testing is crucial for elimination. This study found many patients with hepatitis C risk factors in hospitals were not tested, indicating missed opportunities for care and treatment.

Area of Science:

  • Hepatology
  • Public Health
  • Infectious Diseases

Background:

  • Achieving hepatitis C elimination requires increased testing among at-risk populations.
  • Hospitals present opportunities for hepatitis C screening and linkage to care.
  • Identifying gaps in the hepatitis C testing cascade is essential for improving care.

Purpose of the Study:

  • To evaluate the hepatitis C testing cascade for patients with indications for testing at a regional hospital in Victoria, Australia.
  • To identify missed opportunities in hepatitis C care among hospital inpatients and emergency department attendees.
  • To determine predictors of hepatitis C care engagement, including testing and treatment.

Main Methods:

  • Retrospective study of adult hospital inpatients and emergency department attendees from 2018-2021.
  • Inclusion criteria: indications for intravenous drug use (IDU) or hepatitis C diagnosis.
  • Data sources included hospital admissions, pathology, pharmacy, and outpatient records. Logistic regression was used to analyze predictors of care.

Main Results:

  • Of 79,923 adult admissions, 1345 (1.7%) had IDU codes and 628 (0.8%) had hepatitis C codes (N=1892).
  • Hepatitis C virus (HCV) status remained unknown for 1569 (82.9%) patients at study end.
  • Emergency department admissions were linked to a 3.29-fold increased odds of not receiving hepatitis C care.

Conclusions:

  • Over 2% of inpatients had indications for hepatitis C testing, yet most were not tested during their hospital contact.
  • Significant opportunities for hepatitis C testing and linkage to care are being missed within hospital settings.
  • Integrating hepatitis C testing and linkage strategies into hospital departments with high-risk populations is vital for regional elimination efforts.

Keywords:
cascade of carehepatitis Chepatitis C carehepatitis C testinghospitalsmicro-eliminationpeople who use drugsretention in care

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