Department of Gastroenterology, Campbelltown Hospital, Sydney, NSW, Australia.
Department of Gastroenterology, Campbelltown Hospital, Sydney, NSW, Australia; Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, NSW, Australia.
Public Health Res Pract. 2021 Sep 8;31(3):30342010. doi: 10.17061/phrp30342010.
To determine hepatitis C virus (HCV) treatment rates among those newly diagnosed with the virus in the South Western Sydney Local Health District (SWSLHD) in NSW, Australia.
Cross-sectional study of patients newly diagnosed with HCV in SWSLHD, based on local Public Health Unit notification data from the second half of 2017.
A total of 200 consecutive notifications were enrolled in the study. Either the ordering clinician was interviewed, and/or data linkage with local hospital records performed, to determine rates of antiviral treatment in this cohort. Outcomes measured included the proportion of patients: started on antiviral treatment; referred to specialists for consideration of treatment; HCV ribonucleic acid (RNA) negative; and lost to follow-up. Descriptive analysis of factors contributing to those lost to follow-up was performed where available.
The follow-up outcome of 93% of patients was traced. General Practitioners (GPs) diagnosed a similar number (102) of new HCV cases to those diagnosed by specialists (94). After detecting a patient as HCV antibody positive and confirming active infection, GPs preferred to refer patients to specialists (53%), rather than further evaluate and treat patients themselves (5%). The remainder of cases from the GP-detected group were lost to follow-up (26%), or HCV RNA negative (16%). Among the speciliast-detected patients, 41% were treated, 18% were lost to follow-up, 20% were RNA negative and the remainder were not treated for reasons including a concurrent diagnosis of hepatocellular carcinoma, or death. The most common reason patients were not started on antiviral treatment was loss to follow-up.
We found that less than half (47%) of people in South Western Sydney newly diagnosed with HCV, in whom treatment was indicated, received antiviral medication in the 12 months following diagnosis.This figure excludes the 25% cases referred from general practice to specialists, in whom the treatment status is unknown. Approximately one in five newly diagnosed patients (22%) were lost to follow-up and 18% were RNA negative, indicating they had no active HCV infection.
确定澳大利亚新南威尔士州南悉尼西部地区卫生署（SWSLHD）新诊断出的丙型肝炎病毒（HCV）患者的治疗率。
基于 SWSLHD 当地公共卫生部门 2017 年下半年的通知数据，对新诊断出 HCV 的患者进行的横断面研究。
本研究共纳入 200 例连续通知患者。对开单医生进行访谈，并/或进行与当地医院记录的数据链接，以确定该队列中的抗病毒治疗率。测量的结果包括开始接受抗病毒治疗的患者比例、转介给专家考虑治疗的患者比例、HCV 核糖核酸（RNA）阴性的患者比例和失访的患者比例。在有条件的情况下，对导致失访的因素进行了描述性分析。
93%的患者的随访结果得以追踪。全科医生（GP）诊断的新 HCV 病例数与专家诊断的病例数相似（102 例）。在检测到患者 HCV 抗体阳性并确认存在活动性感染后，GP 更倾向于将患者转介给专家（53%），而不是进一步评估和治疗患者（5%）。GP 检测组中其余病例失访（26%）或 HCV RNA 阴性（16%）。在专家检测的患者中，41%接受了治疗，18%失访，20%RNA 阴性，其余患者因同时诊断为肝细胞癌或死亡等原因未接受治疗。患者未开始抗病毒治疗的最常见原因是失访。
我们发现，在新南威尔士州西南部新诊断出 HCV 且需要治疗的患者中，只有不到一半（47%）的患者在诊断后 12 个月内接受了抗病毒药物治疗。这一数字不包括从全科医生转介到专家的 25%病例，他们的治疗情况尚不清楚。大约五分之一的新诊断患者（22%）失访，18%的 RNA 阴性，表明他们没有活动性 HCV 感染。
