Source: Abstract # FRI-179 Integrated healthcare system implementation of one time hepatitis C virus testing for patients
born between 1945 and 1965 with linkage to care –J. M. Levin et al.
Background and Aims: In the United States persons born between 1945 and 1965 account for 75% of reported Hepatitis
C and 73% of all hepatitis C associated mortality. In 2012 the CDC made the recommendation to screen all adults born
between 1945 and 1965 for hepatitis C virus (HCV). Our integrated healthcare system implemented a workflow such that
every newly diagnosed HCV patient born between 1945 and 1965 was linked to an infectious disease provider. The purpose
of this study was to assess the success of that linkage to care process.
SSM Health Dean Medical Group implemented a health maintenance request reminder for primary care
providers to initiate a one time HCV antibody for all patients born between 1945 and 1965.
Medical records were then reviewed for those patients. Patients identified with positive antibody had a
reflex lab to test for HCV RNA. Patients with positive antibody and detected virus were referred to
infectious disease and set up with an appointment for treatment assessment. Pharmacy screened
patients to verify attempts were made to set up an appointment. HCV treatment was managed by a
collaborative care team comprised of an infectious disease provider, HCV nurse, and a pharmacist. The
primary outcome was percent of patients linked to care. Secondary endpoints include time from
diagnosis to office visit, fibrosis stage, and SVR 12.
At the time of analysis11,277patients born between1945 and 1965 had been screened for HCV antibody.
Of those patients screened without prior HCV diagnosis, 158 (1.40%) had positive HCV antibody
and 36 (0.32%) with detected HCV viral RNA. One patient was excluded from analysis based on detected
but unquantifiable viral load. Another patient was excluded based on transferring care after initial office visit.
Of the 34 patients analyzed 100% of them were linked to infectious disease. A total of 7 patients (20.6%)
were started on therapy and 7 patients (20.6%) had completed therapy at time of abstract submission.
Insurance companies denied coverage for 4 patients (11.8%) for not meeting fibrosis stage criteria. The
remaining 16 patients (47.0%) were awaiting office visits or insurance approval. Updated results will
be presented at the 2017 International Liver Conference.
Conclusions: Linkage to care and treatment remains a major global barrier to reduce spread of infection and disease. Our
health system was able to link all patients to care and treat those eligible.
Share This Page