HCV micro-elimination in diabetes care: A multicenter, prospective quality improvement program in Taiwan

People with diabetes (PWD) exhibit a higher prevalence of Hepatitis C virus (HCV) infection, making them a crucial population for HCV screening and micro-elimination efforts. In light of the first published interdisciplinary consensus on managing/screening HCV in PWD, this study aims to evaluate the results and identify effective strategies for incorporating HCV screening and treatment into an existing diabetes care model managed by case managers.

This multicenter prospective program, initiated by a diabetes society, involved eighteen centers in Taiwan. Each center developed strategies to enhance HCV screening and streamline linkage to HCV care for PWD. Data on screening, diagnosis, and direct-acting antiviral (DAA) treatment were collected. Hospitals were ranked by the average number of monthly DAA treatments, and the strategies of the top five centers were compared with others.

Over a median period of 6.1 months, 28,436 patients were screened, and 1379 (4.8 %) tested positive for anti-HCV antibodies (Ab). A total of 333 (24.1 %) patients were positive for HCV RNA, of whom 288 (86.4 %) received DAA treatment. Overall, 25 strategies were adopted, with the more effective being: the involvement of multidisciplinary healthcare professionals in the program, automation of information technology to search for HCV history, and patient recall for HCV Ab screening.

This program pioneered the evaluation of integrating of HCV screening and treatment in PWD, providing strategic insights into HCV micro-elimination through efficient patient identification and collaborative HCV management.