KMID : 1040620210270010136
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Clinical and Molecular Hepatology 2021 Volume.27 No. 1 p.136 ~ p.143
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Scaling up the in-hospital hepatitis C virus care cascade in Taiwan
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Huang Chung-Feng
Wu Pey-Fang Yeh Ming-Lun Huang Ching-I Liang Po-Cheng Hsu Cheng-Ting Hsu Po-Yao Liu Hung-Yin Huang Ying-Chou Lin Zu-Yau Chen Shinn-Cherng Huang Jee-Fu Dai Chia-Yen Chuan Wan-Long Yu Ming-Lung
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Abstract
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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.
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KEYWORD
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HCV, Reflex testing, Care cascade, Elimination
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