Little information exists regarding the actual outcomes of institutional screening programs for Hepatitis C.
Dr Holly Groom and colleagues determined the outcomes of implementing clinical care guidelines for Hepatitis C screening, evaluation, and treatment in a large urban Veterans Affairs Medical Center.
The researchers undertook a retrospective review of all patients tested for Hepatitis C at the Minneapolis Veterans Affairs Medical Center between 2000 and 2001.
The team used logistic regression to determine factors related to successful referral and treatment.
|73% of Hep C virus -RNA-positive patients attended a specialty Hep C clinic|
|Journal of Clinical Gastroenterology|
The team screened during this period 36,422 unique patients for Hepatitis C virus risk factors.
The team collected 12,485 Hepatitis C virus enzyme-linked immunoassay antibody tests.
The researchers found that Hepatitis C virus antibodies were positive in 5% of patients and 4% were Hepatitis C virus -RNA-positive.
Of Hepatitis C virus -RNA-positive patients, 83% were referred, 73% attended the Hepatitis clinic, and 45% received liver biopsies.
The researchers found that patients referred had significantly fewer comorbidities, known marital status, and greater prior clinic attendance than those not referred.
Overall, 124 patients with established fibrosis received antiviral therapy.
Of these, 32% attended clinic, and 24% were from a viremic cohort.
The team found that white race, fewer major medical problems, and age less than 60 years predicted antiviral treatment.
Sustained virologic response occurred in 37% of treated patients, and in 9% of the viremic cohort.
Patients with a sustained virologic response include 17 patients with stage 3 to 4 fibrosis.
Dr Groom‘s team concluded, "This screening and referral program resulted in 73% of Hepatitis C virus -RNA-positive patients attending a specialty Hepatitis C clinic."
"Of these, 24% were most likely to benefit and received antiviral therapy."
"Measures to increase referral, engagement in care, and antiviral treatment are needed."