Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan.
School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan.
Viruses. 2023 Mar 24;15(4):827. doi: 10.3390/v15040827.
Community-based screening for the hepatitis C virus (HCV) decreased during the COVID-19 pandemic. We developed a collaborative referral model between a primary clinic (Liouguei District Public Health Center, LDPHC) and a tertiary referral center to increase HCV screening and treatment uptake in a mountainous region of Taiwan. Once-in-a-lifetime hepatitis B and C screening services established by the Taiwan National Health Insurance were performed at LDPHC. Antibody-to-HCV (anti-HCV)-seropositive patients received scheduled referrals and took a shuttle bus to E-Da hospital for HCV RNA testing on their first visit. Direct-acting antiviral agents (DAAs) were prescribed for HCV-viremic patients on their second visit. From October 2020 to September 2022, of 3835 residents eligible for HCV screening in Liouguei District, 1879 (49%) received anti-HCV testing at LDPHC. The overall HCV screening coverage rate increased from 40% before referral to 69.4% after referral. Of the 79 anti-HCV-seropositive patients, 70 (88.6%) were successfully referred. Of the 38 HCV-viremic patients, 35 (92.1%) received DAA therapy, and 32 (91.4%) achieved sustained virological response. The collaborative referral model demonstrates a good model for HCV screening and access to care and treatment in a Taiwan mountainous region, even during the COVID-19 pandemic. Sustained referral is possible using this routine referral model.
在 COVID-19 大流行期间，基于社区的丙型肝炎病毒（HCV）筛查减少了。我们开发了一种基层诊所（六龟区公共卫生中心，LDPHC）和三级转诊中心之间的合作转诊模式，以增加台湾山区的 HCV 筛查和治疗参与度。LDPHC 提供了台湾全民健康保险提供的终身一次的乙型肝炎和丙型肝炎筛查服务。抗 HCV（抗 HCV）阳性的患者在首次就诊时接受计划转诊，并乘坐班车前往义大医院进行 HCV RNA 检测。HCV 病毒血症患者在第二次就诊时被开具直接作用抗病毒药物（DAAs）。从 2020 年 10 月到 2022 年 9 月，在六龟区有 3835 名符合 HCV 筛查条件的居民中，有 1879 人（49%）在 LDPHC 接受了抗 HCV 检测。整体 HCV 筛查覆盖率从转诊前的 40%增加到转诊后的 69.4%。在 79 名抗 HCV 阳性患者中，有 70 名（88.6%）成功转诊。在 38 名 HCV 病毒血症患者中，有 35 名（92.1%）接受了 DAA 治疗，32 名（91.4%）达到了持续病毒学应答。该合作转诊模式展示了一种在台湾山区进行 HCV 筛查和获得护理和治疗的良好模式，即使在 COVID-19 大流行期间也是如此。使用这种常规转诊模式可以持续转诊。
