Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 18;16(6):979.
doi: 10.3390/v16060979.

Missed Opportunities: A Retrospective Study of Hepatitis C Testing in Hospital Inpatients

Christine Roder  1   2 , Carl Cosgrave  3 , Kathryn Mackie  4   5 , Bridgette McNamara  1   2   6 , Joseph S Doyle  7   8 , Amanda J Wade  1   2   7
Affiliations

Missed Opportunities: A Retrospective Study of Hepatitis C Testing in Hospital Inpatients

Christine Roder et al. Viruses. .

Abstract

Increasing testing is key to achieving hepatitis C elimination. This retrospective study aimed to assess the testing cascade of patients at a regional hospital in Victoria, Australia, who inject drugs or are living with hepatitis C, to identify missed opportunities for hepatitis C care. Adult hospital inpatients and emergency department (ED) attendees from 2018 to 2021 with indications for intravenous drug use (IDU) or hepatitis C on their discharge or ED summary were included. Data sources: hospital admissions, pathology, hospital pharmacy, and outpatients. We assessed progression through the testing cascade and performed logistic regression analysis for predictors of hepatitis C care, including testing and treatment. Of 79,923 adults admitted, 1345 (1.7%) had IDU-coded separations and 628 (0.8%) had hepatitis C-coded separations (N = 1892). Hepatitis C virus (HCV) status at the end of the study was unknown for 1569 (82.9%). ED admissions were associated with increased odds of not providing hepatitis C care (odds ratio 3.29, 95% confidence interval 2.42-4.48). More than 2% of inpatients at our hospital have an indication for testing, however, most are not being tested despite their hospital contact. As we work toward HCV elimination in our region, we need to incorporate testing and linkage strategies within hospital departments with a higher prevalence of people at risk of infection.

Keywords: cascade of care; hepatitis C; hepatitis C care; hepatitis C testing; hospitals; micro-elimination; people who use drugs; retention in care.

PubMed Disclaimer

Conflict of interest statement

C.R. has received funding from Gilead Sciences and Deakin University that is not related to this study. A.J.W. has received funding from AbbVie and NHMRC that is not related to this study. J.S.D. has received funding from AbbVie and Gilead Sciences that is not related to this study. K.M.s institute has received funding from Gilead Sciences, ASHM and ViiV Healthcare that is not related to this study. There is no other conflict of interest to declare.

Figures

Figure 1
Figure 1
Cascade of care for patients with an indication of injecting-drug-use-related separations at University Hospital Geelong from 2018 to 2021. n = 1345 documented (measured and historical) positive test results for hepatitis C antibody, and RNA tests are shown in pink, with inferred positive tests shown in orange.
Figure 2
Figure 2
Cascade of care for patients with hepatitis C-coded separations at University Hospital Geelong from 2018 to 2021. n = 628 documented (measured and historical) positive test results for hepatitis C antibody, and RNA tests are shown in pink, with inferred positive tests shown in orange.
See this image and copyright information in PMC

References

    1. Cui F., Blach S., Mingiedi C.M. Global reporting of progress towards elimination of hepatitis B and hepatitis C. Lancet Gastroenterol. Hepatol. 2023;8:332–342. doi: 10.1016/S2468-1253(22)00386-7. - DOI - PubMed
    1. de Graaff B., Yee K.C. Uptake of and expenditure on direct-acting antiviral agents for hepatitis C treatment in Australia. Appl. Health Econ. Health Policy. 2018;16:495–502. doi: 10.1007/s40258-018-0392-8. - DOI - PubMed
    1. Scott N., Hainsworth S.W. Heterogeneity in hepatitis C treatment prescribing and uptake in Australia: A geospatial analysis of a year of unrestricted treatment access. J. Virus Erad. 2018;4:108–114. doi: 10.1016/S2055-6640(20)30253-3. - DOI - PMC - PubMed
    1. Valerio H., Alavi M. Opportunities to enhance linkage to hepatitis C care among hospitalized people with recent drug dependence in New South Wales, Australia: A population-based linkage study. Clin. Infect. Dis. 2021;73:2037–2044. doi: 10.1093/cid/ciab526. - DOI - PubMed
    1. Wade A.J., McCormack A. Aiming for elimination: Outcomes of a consultation pathway supporting regional general practitioners to prescribe direct-acting antiviral therapy for hepatitis C. J. Viral Hepat. 2018;25:1089–1098. doi: 10.1111/jvh.12910. - DOI - PubMed