Authors (including presenting author) :
Li LK, Sakhrani N, Lo FH, Kung KN, Hung YL, Ng YB
Affiliation :
Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV), which can cause both acute and chronic hepatitis, ranging in severity from a mild illness to a serious, lifelong illness including liver cirrhosis and cancer. WHO (World Health Organization) estimated that in 2019, approximately 290 000 people died from HCV, mostly from cirrhosis and hepatocellular carcinoma. With the advancement of medicine, HCV is curable nowadays, the development of Direct-acting Antiviral (DAA) medications can cure most patients with HCV infection with short treatment duration, minimal side effects and cure rate above 90%. However, the access to HCV treatment remains limited globally and locally. In 2015, only 20% of persons living with HCV infection globally knew their diagnosis, of which 7% received treatment. In Hong Kong, a modelling study gave a diagnosis rate at 22% and treatment coverage rate of those diagnosed (detectable viral load - HCVRNA) at 6%. In order to meet the goal established by WHO aiming to eliminate HCV by 2030, an active tracing exercise was launched.
Objectives :
Trace the patients with reactive anti-HCV serology, call them back for early workup and refer to hepatologists for early treatment in case of detectable HCVRNA.
Methodology :
A systemic look back exercise has been undertaken since February 2022, targeted on patients with reactive anti-HCV serology and having old medical follow up in United Christian Hospital. Patients with history of detectable HCVRNA and treatment naive would be referred to hepatologists for earlier workup or treatment. For those who have not yet checked their HCVRNA level, they would be called back and blood test would be arranged for early workup.
Result & Outcome :
Totally 174 cases have been reviewed, 37 patients (21%) were checked HCVRNA negative which were considered as spontaneous cured. 11 patients (6%) have been treated in other hospitals or private settings. 77 patients (44%) were checked HCVRNA positive and has been referred to hepatologists early for treatment. 13 patients (7%) had been given blood test reminders but not yet taken blood. 8 patients (5%) were in poor prognosis and not fit for treatment after review by hepatologists. 20 patients (11%) were dead while remaining 6% patients were unable to be contacted or out of town.
To achieve the goal set by WHO, this exercise allows accelerating the pace as well as helping them by early treatment to avoid HCV related complications.
