Year 2023 / Volume 115 / Number 4
Original
Outcomes of an automated alert system from Microbiology to link diagnosis to treatment in patients with hepatitis C virus

181-187

DOI: 10.17235/reed.2022.8716/2022

Carlos Alventosa Mateu, María Dolores Ocete Mochón, Juan José Urquijo Ponce, Mercedes Latorre Sánchez, Inmaculada Castelló Miralles, Miguel García Deltoro, Enrique Ortega González, María José Bonet Igual, Concepción Gimeno Cardona, Moisés Diago Madrid,

Abstract
Introduction: simplification strategies for the care circuit of patients with hepatitis C virus (HCV) are key to achieve eradication. An electronic identification system was set up for HCV serology to link diagnosis to specialist management, aimed to reduce patient loss. Material and methods: a retrospective, single-center study was performed in patients with HCV identified from 15/3/2020 to 15/12/2021, using an alert system from Microbiology that notified specialists of positive cases. The patient was contacted and appointed a Fibroscan® and viral load measurement, with antiviral therapy prescribed on the same day. Origin, public health data, patient location rate and antiviral therapy prescription were recorded. Results: of 174 patients identified, 171 had positive viremia, with a mean age of 59.6 ± 15.9 years, 61.5 % were males and 81.2 % were Spanish nationals. Origin in the outpatient setting predominated (57.9 %, 99/171), particularly Primary Care (51/171), penitentiaries (21/171) and addiction units (14/171). Overall, 43.3 % (74/171) were aware of their diagnosis; 19.4 % (20/103) of patients had F3 fibrosis and 25.2 % (26/103) had F4 fibrosis. Also, 78.4 % (134/171) were deemed candidates for treatment. Of these, 74.6 % (100/134) were located and treatment was initiated, and all those who completed their treatment achieved a sustained viral response (96/96). This system managed 58.5 % (100/171) of the patients identified. The only association found between antiviral therapy and patient variables was comorbidities with being untreated (OR, 7.14; p ˂ 0.001). Conclusions: this alert system allows to minimize patient loss in the care circuit and provides high rates of treated patients.
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References
1. Chen Q, Ayer T, Bethea E, et al. Changes in hepatitis C burden and treatment trends in Europe during the era of direct-acting antivirals: a modelling study. BMJ Open 2019;9(6):e02672.
2. Baumert TF, Berg T, Lim JK, et al. Status of direct-acting antiviral therapy for HCV infection and remaining challenges. Gastroenterology 2019;156(2):431- 45.
3. Ioannou GN, Feld JJ. What are the benefits of a sustained virologic response to direct-acting antiviral therapy for hepatitis C virus infection? Gastroenterology 2019;156(2):446-60.
4. Secretaría General de Sanidad y Consumo. Ministerio de Sanidad, Consumo y Bienestar Social. Plan Estratégico para el Abordaje de la Hepatitis C en el Sistema Nacional de Salud (PEAHC); octubre 2020. [Acceso 8 de enero de 2022]. Disponible en: https://www.mscbs.gob.es/ciudadanos/enfLesiones/enfTransmisibles/hepatitisC/PlanEstrategicoHEPATITISC/home.htm
5. World Health Organization. Combating hepatitis B and C to reach elimination by 2030. Advocacy brief. WHO: Geneva, Switzerland; May 2016.
6. Cabezas J, García F, Calleja Panero JL et al. Fundamentos para aplicar una estrategia de cribado poblacional de la hepatitis C en España Rev. Esp Enferm Dig 2020;112(1):64-70
7. Andaluz I, Arcos MM, Montero MD, et al. Pacientes con hepatitis C perdidos en el sistema: aspectos éticos-legales y resultados de su búsqueda. Rev Esp Enferm Dig 2020;112(7):532-7
8. Crespo J, Tejerina A, Cuadrado A, et al. Estrategia para la eliminación de la hepatitis C en Cantabria. Rev Esp Enferm Dig 2020:112(7):565-70
9. Seoane Blanco L, Soto Sánchez J, Sierra Dorado G, et al. Búsqueda activa de pacientes con hepatitis C en atención primaria. Rev Esp Enferm Dig 2021;113(12):820-4
10. Crespo J, Albillos A, Buti M, et al. Eliminación de la hepatitis C. Documento de posicionamiento de la Asociación Española para el Estudio del Hígado (AEEH). Rev Esp Enferm Dig 2019; 111(11):862-73.
11. European Association for the Study of the Liver (EASL). Policy Statement on Hepatitis C Elimination. June 2019.
12. Del Pino Bellido P, Guerra Veloz MF, Cordero Ruiz P, et al. Pacientes con hepatitis C crónica perdidos en el sistema: factores predictores de no derivación o inasistencia a unidades de hepatología. Rev Esp Enferm Dig 2021;113(12):833-39.
13. Konerman MA, Lok ASF. Hepatitis C treatment and barriers to eradication. Clin Transl Gastroenterol 2016;7(9):1-6.
14. Simpson H, Manley P, Lawler J, et al. Distance to treatment as a factor for loss to follow up of hepatitis C patients in North East England. J Public Health (Oxf) 2019;41(4):700-6.
15. Botterman R, Verhelst X, Buffel V, et al. Hepatitis C in two general practices in Flanders, Belgium: is there a need to reconsider current screening recommendations? Acta Clin Belg 2021;76(6):462-9
16. Ampuero J, Jimeno C, Quiles R, et al. Impact of comorbidities on patient outcomes after interferon-free therapy-induced viral eradication in hepatitis C. J Hepatol 2018; 68(5): 940-8.
17. Horwood J, Clement C, Roberts K, et al. Increasing uptake of hepatitis C virus infection case-finding, testing, and treatment in Primary Care: evaluation of the HepCATT (Hepatitis C Assessment Through to Treatment) trial. Br J Gen Pract 2020;70(697):e581-8.
18. Turner BJ, Rochat A, Lill S, et al. Hepatitis C virus screening and care: complexity of implementation in Primary Care practices serving disadvantaged populations. Ann Intern Med 2019;171(12):865-74.
19. Mravčík V, Strada L, Štolfa J, et al. Factors associated with uptake, adherence, and efficacy of hepatitis C treatment in people who inject drugs: a literature review. Patient Prefer Adherence 2013;7:1067-75.
20. Morales-Arraez D, Alonso-Larruga A, Díaz-Flores F, et al. Predictive factors for not undergoing RNA testing in patients found to have hepatitis C serology and impact of an automatic alert. J Viral Hepat 2019;26(9):1117-23.
21. Aldridge RW, Story A, Hwang SW, et al. Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis. Lancet (London) 2018;391(10117):241-50.
22. Connoley D, Francis-Graham S, Storer M, et al. Detection, stratification and treatment of hepatitis C-positive prisoners in the United Kingdom prison estate: development of a pathway of care to facilitate the elimination of hepatitis C in a London prison. J Viral Hepat 2020;27(10):987-95.
23. Crespo J, Grupo Técnico de Cribado de la Infección por el VHC. Guía de cribado de la infección por el virus de la hepatitis C en España. Rev Esp Enferm Dig 2021:113(2):81-2.
24. Krekulova L, Honzák R, Riley LW. Viral hepatitis C pandemic: Challenges and threats to its elimination. J Viral Hepat. 2021 May;28(5):694-8.
25. Yen HH, Su PY, Liu II, et al. Retrieval of lost patients in the system for hepatitis C microelimination: a single-center retrospective study. BMC Gastroenterol. 2021 May 8;21(1):209.
26. Guerra Veloz MF, Pino Bellido P, Cordero Ruiz P, et aI. HCV micro-elimination strategies: an interventional study in diagnosed patients without access to the system. Liver Int. 2021;41(5):928–33.
27. López R, Arias A, Rodríguez F, et al. Significant improvement in diagnosis of hepatitis C virus by a one-step strategy in a central laboratory: an optimal tool for hepatitis C elimination? J Clin Microbiol 2019;58(1):e01815-19.
28. García F, Domínguez R, Casado M, et al. The simplification of the diagnosis process of chronic hepatitis C is cost-effective strategy. Enferm Infecc Microbiol Clin 2019;37(10):634-41.
29. Crowley D, Murtagh R, Cullen W, et al. Hepatitis C virus infection in Irish drug users and prisoners - A scoping review. BMC Infect Dis 2019;19(1):1-27.
30. Dolan K, Wirtz AL, Moazen B, et al. Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees. Lancet. 2016 Sep 10;388(10049):1089-102.
31. García Deltoro M, Ocete Mochón MD, Diago Madrid M, et al. CRIVALVIR-FOCUS-2 Cribado poblacional de VHB y VHC en tiempos de pandemia SarsCov-2. Departamento de Salud Hospital General Universitari de València. Póster en el 46º congreso anual de la Asociación para el Estudio del Hígado. Madrid 14-16 Junio 2020. Gastroenterol Hepatol 2021; 44 (Especial Congreso 2): 75.
32. Cuadrado A, Cobo C, Mateo M, et al. Telemedicine efficiently improves access to hepatitis C management to achieve HCV elimination in the penitentiary setting. Int J Drug Policy. 2020;88:103031.
33. Perez Castano Y, Chouza Perez JM, Sanz Largo V, et al. Linkage to care strategy for the micro-elimination of hepatitis C among parenteral drug users on methadone replacement therapy in Gipuzkoa. Rev Esp Enferm Dig. 2020;112(7):545–9.
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Alventosa Mateu C, Ocete Mochón M, Urquijo Ponce J, Latorre Sánchez M, Castelló Miralles I, García Deltoro M, et all. Outcomes of an automated alert system from Microbiology to link diagnosis to treatment in patients with hepatitis C virus. 8716/2022


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Publication history

Received: 15/02/2022

Accepted: 01/07/2022

Online First: 31/08/2022

Published: 03/04/2023

Article revision time: 130 days

Article Online First time: 197 days

Article editing time: 412 days


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