Related Experiment Video
Updated: May 29, 2025
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Road to Hepatitis C Elimination in Israel: Improvements in Linkage to Care (2009-2020)
Ayelet A Basson1, Clara Weil1, Steven E Marx2,3
1Maccabi Healthcare Services, Tel Aviv, Israel.
Insights
Hepatitis C virus (HCV) linkage to care improved with direct-acting antivirals (DAAs) access, but COVID-19 caused temporary declines. This study tracked HCV care cascade and pandemic impacts in Israel.
Area of Science:
- Hepatology
- Public Health
- Infectious Diseases
Background:
- Disrupted linkage to care is a significant barrier to hepatitis C virus (HCV) elimination.
- High attrition rates hinder progress towards HCV elimination goals.
Purpose of the Study:
- To describe the flow through the HCV care cascade from 2009-2020.
- To analyze monthly patterns in HCV care during the COVID-19 pandemic in Israel (2020).
Main Methods:
- Utilized data from Maccabi Healthcare Services, a large Israeli healthcare provider.
- Described HCV care cascade from antibody (Ab+) test to sustained virological response (SVR).
- Analyzed monthly HCV care data for 2020.
Main Results:
- Among 2809 Ab+ patients, 1417 (50.4%) were PCR+; median times to confirmation and treatment were reduced post-DAA era.
- 55.5% of PCR+ patients purchased direct-acting antiviral agents (DAAs), with high SVR rates (413/416).
- 2020 data showed a decline in HCV care during the initial COVID-19 pandemic closure.
Conclusions:
- HCV linkage to care improved over time with increased DAA access.
- Despite overall improvements, access to HCV care declined temporarily in 2020 due to the pandemic.
Introduction:
Disrupted linkage to care is a major barrier to hepatitis C virus (HCV) elimination leading to high attrition rates. This study aimed to describe (1) flow through the HCV care-cascade (2009-2020), and (2) monthly patterns in HCV care during the coronavirus disease 2019 (COVID-19) pandemic (2020) in Israel.
Methods:
Data were obtained from Maccabi Healthcare Services, a 2.6-million-member healthcare provider in Israel. Flow through the HCV care-cascade in 2009-2020 was described from individuals' first positive HCV antibody (Ab+) test to sustained virological response (SVR), and monthly data were obtained on individuals newly attaining a given stage in the HCV care-cascade in 2020.
Results:
Among 2809 new patients who were Ab+, 2651 (94.4%) had an HCV polymerase chain reaction (PCR) test, and 1417 (50.4%) were PCR+ during the study. Median time from Ab+ to PCR+ was 3.9 years, with 39.7% PCR+ within 12 months. Median time from PCR+ to HCV treatment was 3.3 years, with 639 (55.5%) of patients who were PCR+ purchasing direct-acting anti-viral agents (DAAs), and 413/416 patients attained SVR. A significant reduction was observed in the time from first HCV detection (Ab+) to HCV confirmation (PCR+) and from PCR+ test to HCV treatment purchase in the pre-DAA era compared to the post-DAA. Monthly data during 2020 (Part B) indicates a decline in the numbers of patients receiving HCV care during the first pandemic-related closure.
Conclusion:
Real-world data from a nationally representative healthcare provider database suggest that HCV linkage to care improved over time alongside increased access to DAAs, despite observed declines in access to care in 2020.
Related Concept Videos
01:10Retrovirus Life Cycles
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...