Viral hepatitis notifications: a cohort study of enhanced local follow-up in Victoria, Australia

Australia needs to increase linkage to viral hepatitis care and treatment to achieve the 2030 elimination targets. This study assessed the intervention of enhanced local public health (PH) follow-up of hepatitis B and hepatitis C notifications on linkage to care and treatment, compared with standard PH management, in the Barwon South West and Gippsland regions in Victoria.

Innovative models to increase viral hepatitis testing and linkage to care and treatment are required, especially in regional Australia.

Retrospective cohort study.

Study periods were March to August 2022 (standard PH management), and September 2022 to February 2023 (enhanced local PH follow up). Notifications from correctional facilities were excluded. Outcomes by study period compared time to complete hepatitis C diagnosis, hepatitis C treatment initiation, hepatitis B viral load measurement and referral for hepatitis B care. A Kaplan-Meier survival analysis and Cox regression model were performed.

A total of 190 notifications met inclusion criteria, and 174 people were included in the analysis - 133 with hepatitis C and 41 with hepatitis B (16 were lost to follow-up). The probability of having an incomplete hepatitis C diagnosis within 180 days from notification was 2.33 (95% CI 1.40, 3.89) times higher among patients receiving standard PH management compared with enhanced local PH follow-up. The probability of not being referred to hepatitis B care within 90 days from notification was 2.78 times (95% CI 1.13, 6.82) higher among patients receiving standard PH management compared with enhanced local PH follow-up.

Enhanced local PH follow-up increased the proportion of hepatitis C notifications with a complete diagnosis and hepatitis B notifications referred to care. Local PH follow-up presents a unique opportunity to accelerate progress towards the 2030 viral hepatitis elimination targets in Victoria.