Citarella Anna, Cammarota Simona, Bernardi Francesca F, Coppola Carmine, D'Antò Maria, Fogliasecca Marianna, Giusto Elio, Masarone Mario, Salomone Megna Angelo, Sellitto Carmine, Servodio Rosa, Smaldone Massimo, Staiano Laura, Trama Ugo, Conti Valeria, Persico Marcello
LinkHealth Health Economics, Outcomes & Epidemiology s.r.l., 80143 Naples, Italy.
General Direction of Health Care & Regional Health System Coordination, Drug & Device Politics, Campania Region, 80143 Naples, Italy.
Life (Basel). 2020 Dec 18;10(12):359. doi: 10.3390/life10120359.
Hepatitis C virus (HCV) infection remains a pressing public health issue. Our aim is to assess the linkage to care of patients with HCV diagnosis and to support the proactive case-finding of new HCV-infected patients in an Italian primary care setting. This was a retrospective cohort study of 44 general practitioners (GPs) who managed 63,955 inhabitants in the Campania region. Adults with already known HCV diagnosis or those with HCV high-risk profile at June 2019 were identified and reviewed by GPs to identify newly diagnosed of HCV and to assess the linkage to care and treatment for the HCV patients. Overall, 698 HCV patients were identified, 596 with already known HCV diagnosis and 102 identified by testing the high-risk group (2614 subjects). The 38.8% were already treated with direct-acting antivirals, 18.9% were referred to the specialist center and 42.3% were not sent to specialist care for treatment. Similar proportions were found for patients with an already known HCV diagnosis and those newly diagnosed. Given that the HCV infection is often silent, case-finding needs to be proactive and based on risk information. Our findings suggested that there needs to be greater outreach, awareness and education among GPs in order to enhance HCV testing, linkage to care and treatment.
丙型肝炎病毒（HCV）感染仍然是一个紧迫的公共卫生问题。我们的目标是评估HCV诊断患者的医疗服务衔接情况，并支持在意大利基层医疗环境中主动发现新的HCV感染患者。这是一项针对44名全科医生（GP）的回顾性队列研究，这些医生负责坎帕尼亚地区的63,955名居民。2019年6月，已确诊HCV或具有HCV高风险特征的成年人被全科医生识别并进行评估，以确定新诊断的HCV患者，并评估HCV患者的医疗服务衔接和治疗情况。总体而言，共识别出698名HCV患者，其中596名已确诊HCV，102名是通过对高风险组（2614名受试者）进行检测而识别出来的。38.8%的患者已经接受了直接抗病毒药物治疗，18.9%的患者被转诊至专科中心，42.3%的患者未被转诊至专科进行治疗。已确诊HCV的患者和新确诊的患者比例相似。鉴于HCV感染通常没有症状，病例发现需要积极主动，并基于风险信息。我们的研究结果表明，全科医生需要进行更多的宣传、提高认识和开展教育，以加强HCV检测、医疗服务衔接和治疗。
