HEPATITIS C SCREENING, DIAGNOSIS AND FOLLOW-UP CARE
Date
2018
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Abstract
Chronic Hepatitis C Virus (HCV) infection causes more deaths than all infectious diseases
combined. Direct acting antivirals (DAAs) may cure over 90% of HCV infections. The Center
for Disease Control (CDC) recommends screening high risk and baby boomer birth cohorts
(CDC, 2015a). Those testing positive for HCV antibodies require HCV RNA to confirm
infection. Positive HCV RNA necessitates follow-up with a primary care provider (PCP) or
HCV specialist. This project was designed to determine if educating a group of PCPs on CDC
HCV testing sequence would improve diagnosis and follow-up care. An educational
presentation on CDC HCV guidelines was provided to group of PCPs. Rates of HCV screening,
diagnosis and follow-up appointments were collected three months pre/post intervention.
Descriptive statistics were used to compare rates of HCV screening, RNA confirmation and
follow-up care. Although pre-post screening rates were nearly identical with all HCV positive
patients receiving confirmatory diagnosis and follow-up, the overall project impact was not
anticipated. The end result led to automated reflex HCV RNA confirmatory testing, formation of
a hospital/ community task force to examine HCV treatment access, and establishment of a
hospital based HCV clinic. In addition, there were multiple HCV educational presentations for
providers and allied health personnel. There was increased local media attention (television,
newspaper) on the HCV epidemic, which improved community awareness of the need for HCV
screening and treatment.
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Keywords
HCV birth cohort screening, HCV RNA, CDC HCV sequence, HCV link-to-care