Hospital study: 35.9% of anti-HCV-positive patients had no confirmatory HCV-RNA test over five years
A retrospective single-center study of 1,492 anti-HCV-positive patients found 536 without HCV-RNA testing; telephone outreach brought 42 back to the clinic.
A retrospective single-center study of adults screened for hepatitis C antibodies between 31 October 2019 and 31 October 2024 found that more than a third of anti-HCV-positive patients never had a confirmatory HCV-RNA test, according to the paper published via doi.org biomedcentral.com
doi.orgbiomedcentral.comOpen source ↗. Of 220,516 people screened, 1,492 were anti-HCV positive (0.68%; 95% CI, 0.64–0.71). The authors used the hospital information system to evaluate HCV-RNA results, treatment status, survival data and clinic distribution.
Losses at the confirmatory testing stage
Among the 1,492 anti-HCV-positive patients, 406 were HCV-RNA positive (27.2%; 95% CI, 25.0–29.5) and 550 were HCV-RNA negative. The other 536 had not undergone HCV-RNA testing (35.9%; 95% CI, 33.5–38.4). Surgical clinics accounted for the highest proportion of non-testing, 45.9%.
The authors report substantial losses in the hepatitis C care cascade, particularly at the confirmatory HCV-RNA testing stage. They suggest that reflex HCV-RNA testing and automated hospital-based alert systems may help improve linkage to care.
Telephone re-engagement of lost patients
Patients without HCV-RNA testing, and those who remained untreated despite a positive HCV-RNA result, were contacted by telephone and invited to the outpatient clinic biomedcentral.com
doi.orgbiomedcentral.comOpen source ↗. Of 142 patients planned for outreach, 68 were reached (47.9%; 95% CI, 39.8–56.1), and 42 attended the clinic (29.6%; 95% CI, 22.7–37.5).
HCV-RNA positivity was detected in 9 of those who attended, and all 9 initiated antiviral treatment. The authors describe telephone-based re-engagement as feasible for reconnecting selected patients lost to follow-up, but note that its effectiveness requires confirmation in comparative studies.
The study design is retrospective and covers one center, so the figures describe this hospital's records. The authors also point to strategies that address healthcare access barriers among foreign-national patients as a possible way to reduce losses in the care cascade.
