Patients Lost after Anti-HCV-Positive Finding in a Tertiary Care University Hospital: Increased Awareness and Action is Necessary to Eradicate HCV

Objectives: Though there is a global effort to eradicate hepatitis C infection (HCV), several obstacles remain. Many patients infected with the virus are not detected or go untreated. The goal of this study was to identify any barriers to treatment and any difficulties contributing to the elimination of HCV infection at a tertiary care university hospital.
Methods: This was a retrospective review. The hospital data system was searched for records of patients admitted to the hospital for any reason from between 2013 and 2018 who were screened for viral markers and determined to be anti-HCV positive. The follow-up performed was then analyzed.
Results: Viral marker testing was requested for 65,853 patients during the study period. Of those, 64.735 (98.3%) were found to be anti-HCV negative and 1118 (1.7%) were anti-HCV positive. In all, 392 (35.06%) were detected in the gastroenterology department, 417 (37.3%) were patients in the infectious diseases department, and 309 (27.64%) were identified in other clinics, including emergency services, the blood bank, and others. There were 30/392 (7.65%) patients admitted to the gastroenterology clinic who declined a biopsy and/or treatment. In other clinics, 88/309 (28.5%) patients were identified who were not treated for HCV and not followed up because they were not referred to the related specialty department.
Conclusion: It was determined that there was a significant gap in referring patients to the appropriate specialized department following an anti-HCV positive finding and thus to appropriate follow-up and treatment programs.

Patients Lost after Anti-HCV-Positive Finding in a Tertiary Care University Hospital: Increased Awareness and Action is Necessary to Eradicate HCV

GÝRÝÞ VE AMAÇ: Dünya Saðlýk Örgütü, 2030 yýlýna kadar dünyadaki önemli bir saðlýk sorununu olan HCV enfeksiyonunu yok etme hedefini belirlemiþtir. Bu hedefi saðlýk uzmanlarý olarak benimsememize ve bunun için mücadele etmemize raðmen, engellerin ortaya çýkabileceðini gözlemliyoruz. Hepatit C ile enfekte olan tüm hastalar tespit edilemez ve tüm hastalar tedavi edilemez. Amacýmýz, hepatit C'li hastane hastalarýmýza eriþimdeki sorunlarý tespit etmek ve HCV enfeksiyonunun giderilmesinde doðabilecek zorluklarý tespit etmektir.
MATERYAL VE METOD: Hastane veri kayýt sisteminden son 5 yýlda (2013-2018 arasýnda) herhangi bir nedenle hastanede viral belirteçleri istenen ve anti-HCV’nin pozitif olduðu saptanan hastalar tespit edildi. Daha sonra bu hastalarýn akibetleri incelendi.
BULGULAR: 65853 kiþide viral belirteçlere istenmiþti ve 64735 (% 98,3)’ünde anti-HCV negatif, 1118 (% 1,7)’inde anti-HCV pozitif bulundu. Hastalarýn 392'si (% 35,06) gastroenteroloji bölümünde, 417'si (% 37,3) enfeksiyon hastalýklarý bölümünde, 309'u (% 27,64) diðer kliniklerde Anti HCV pozitif tespit edilmiþti. Gastroenteroloji kliniðinde tespit edilip tedavi almamýþ 30/392 (% 7,65) hasta vardý. Çünkü bu hastalar biyopsi ve tedaviyi kabul etmemiþlerdi. Diðer kliniklerde ise, ilgili branþlara yönlendirilmediði için takip edilmemiþ ve tedavi almamýþ 88/309 (% 28,5) hasta tespit edildi.
TARTIÞMA: Hastalarý ilgili uzmanlýk bölümlerine ve dolayýsýyla uygun takip ve tedavi programlarýna yönlendirmede önemli bir boþluk olduðunu tespit ettik.