Scaling up the in-hospital hepatitis C virus care cascade in Taiwan

Chung-Feng Huang; Pey-Fang Wu; Ming-Lun Yeh; Ching-I Huang; Po-Cheng Liang; Cheng-Ting Hsu; Po-Yao Hsu; Hung-Yin Liu; Ying-Chou Huang; Zu-Yau Lin; Shinn-Cherng Chen; Jee-Fu Huang; Chia-Yen Dai; Wan-Long Chuang; Ming-Lung Yu

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자료유형: 학술저널

저자정보: Chung-Feng Huang (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Pey-Fang Wu (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Ming-Lun Yeh (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Ching-I Huang (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Po-Cheng Liang (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Cheng-Ting Hsu (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Po-Yao Hsu (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Hung-Yin Liu (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Ying-Chou Huang (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Zu-Yau Lin (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Shinn-Cherng Chen (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Jee-Fu Huang (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Chia-Yen Dai (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Wan-Long Chuang (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital) Ming-Lung Yu (Hepatobiliary Division Department of Internal Medicine Kaohsiung Medical University Hospital)

저널정보: 대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology 제27권 제1호

발행연도: 2021.1

수록면: 136 - 143 (8page)

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Background/Aims: Obstacles exist in facilitating hepatitis C virus (HCV) care cascade. To increase timely and accurate diagnosis, disease awareness and accessibility, in-hospital HCV reflex testing followed by automatic appointments and a late call-back strategy (R.N.A. model) was applied. We aimed to compare the HCV treatment rate of patients treated with this strategy compared to those without. Methods: One hundred and twenty-five anti-HCV seropositive patients who adopted the R.N.A. model in 2020 and another 1,396 controls treated in 2019 were enrolled to compare the gaps in accurate HCV RNA diagnosis to final treatment allocation. Results: The HCV RNA testing rate was significantly higher in patients who received reflex testing than in those without reflex testing (100% vs. 84.8%, P<0.001). When patients were stratified according to the referring outpatient department, a significant improvement in the HCV RNA testing rate was particularly noted in patients from non-hepatology departments (100% vs. 23.3%, P<0.001). The treatment rate in HCV RNA seropositive patients was 83% (83/100) after the adoption of the R.N.A. model, among whom 96.1% and 73.9% of patients were from the hepatology and non-hepatology departments, respectively. Compared to subjects without R.N.A. model application, a significant improvement in the treatment rate was observed for patients from non-hepatology departments (73.9% vs. 27.8%, P=0.001). The application of the R.N.A. model significantly increased the in-hospital HCV treatment uptake from 6.4% to 73.9% for patients from non-hepatology departments (P<0.001). Conclusions: The care cascade increased the treatment uptake and set up a model for enhancing in-hospital HCV elimination.

#HCV #Reflex testing #Care cascade #Elimination

참고문헌 (26)

참고문헌 신청

World Health Organization (WHO) / Hepatitis C

Yu ML / 2015 / Huge gap between clinical efficacy and community effectiveness in the treatment of chronic hepatitis C: a nationwide survey in Taiwan / Medicine (Baltimore) 94:e690

Yang JF / 2010 / Viral hepatitis infections in southern Taiwan: a multicenter community-based study / Kaohsiung J Med Sci 26:461~469

Chen YY / 2020 / Secular trends and geographic maps of hepatitis C virus infection among 4million blood donors in Taiwan from 1999 to 2017 / Hepatol Commun 4:1193~1205

World Health Organization (WHO) / Global health sector strategy on viral hepatitis 2016-2021. Towards ending viral hepatitis

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