Screening, Linkage to Care and Treatment of Hepatitis C Infection in Primary Care Setting in the South of Italy

Abstract

Hepatitis C virus (HCV) infection remains a pressing public health issue. Our aim is to assess the linkage to care of patients with HCV diagnosis and to support the proactive case-finding of new HCV-infected patients in an Italian primary care setting. This was a retrospective cohort study of 44 general practitioners (GPs) who managed 63,955 inhabitants in the Campania region. Adults with already known HCV diagnosis or those with HCV high-risk profile at June 2019 were identified and reviewed by GPs to identify newly diagnosed of HCV and to assess the linkage to care and treatment for the HCV patients. Overall, 698 HCV patients were identified, 596 with already known HCV diagnosis and 102 identified by testing the high-risk group (2614 subjects). The 38.8% were already treated with direct-acting antivirals, 18.9% were referred to the specialist center and 42.3% were not sent to specialist care for treatment. Similar proportions were found for patients with an already known HCV diagnosis and those newly diagnosed. Given that the HCV infection is often silent, case-finding needs to be proactive and based on risk information. Our findings suggested that there needs to be greater outreach, awareness and education among GPs in order to enhance HCV testing, linkage to care and treatment.

Effectiveness of Direct-Acting Antivirals in Treatment of Elderly Egyptian Chronic Hepatitis C Patients

“…However, several patients were noncompliant with the high rate of LTFU patients despite easy access to our nearby institution and financial coverage of our healthcare services. This highlights the need for applying further stringent monitoring requirements as reported in a previous study [48], and to increase awareness of general practitioners of new case findings, especially the silent HCV-infected patients, and referring them for treatment and care as reported by a recent study [49].…”

Hepatitis C Virus Micro-Elimination Plan in Southern Italy: The “HCV ICEberg” Project

“…Results from recent experience in the Campania region, which involved 44 general practitioners, found that even after identification, 42% of patients were not referred to a specialist center for further evaluation, and only 39% were treated. The authors reported similar findings both in patients with an already known HCV diagnosis and those with a newly diagnosed HCV infection, suggesting the need for greater outreach, awareness, and education among general practitioners (GPs) in order to enhance HCV testing and linkage to care [ 13 ]. The “Telepass project”, based on a hospital recall strategy of anti-HCV patients, revealed that 18.69% of recalled patients, even if aware of their serological status, did not perceive the possibility of being HCV infected as a harmful condition that ought to be further investigated [ 14 ].…”

A territory‐wide opportunistic, hospital‐based HCV screening in the general population from northern Italy: The 1969–1989 birth‐cohort

“…This is not unexpected, as older age had already been associated with an increased risk of carrying HCV infection in other Italian studies, 15,[18][19][20][21] and was confirmed by more recent studies. 12,13,22,23 Thus, age-bracket extension to individuals born before 1969 would seem reasonable, and it has already been planned to follow this first part of the Lombardy screening program.…”