Barwon South West Public Health Unit, Barwon Health, Geelong 3220, Australia.
Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong 3220, Australia.
Viruses. 2024 Jun 18;16(6):979. doi: 10.3390/v16060979.
Increasing testing is key to achieving hepatitis C elimination. This retrospective study aimed to assess the testing cascade of patients at a regional hospital in Victoria, Australia, who inject drugs or are living with hepatitis C, to identify missed opportunities for hepatitis C care. Adult hospital inpatients and emergency department (ED) attendees from 2018 to 2021 with indications for intravenous drug use (IDU) or hepatitis C on their discharge or ED summary were included. Data sources: hospital admissions, pathology, hospital pharmacy, and outpatients. We assessed progression through the testing cascade and performed logistic regression analysis for predictors of hepatitis C care, including testing and treatment. Of 79,923 adults admitted, 1345 (1.7%) had IDU-coded separations and 628 (0.8%) had hepatitis C-coded separations (N = 1892). Hepatitis C virus (HCV) status at the end of the study was unknown for 1569 (82.9%). ED admissions were associated with increased odds of not providing hepatitis C care (odds ratio 3.29, 95% confidence interval 2.42-4.48). More than 2% of inpatients at our hospital have an indication for testing, however, most are not being tested despite their hospital contact. As we work toward HCV elimination in our region, we need to incorporate testing and linkage strategies within hospital departments with a higher prevalence of people at risk of infection.
增加检测是实现丙型肝炎消除的关键。本回顾性研究旨在评估澳大利亚维多利亚州一家区域医院接受注射毒品或患有丙型肝炎的患者的检测链，以确定丙型肝炎护理的错失机会。纳入标准为 2018 年至 2021 年期间因静脉药物使用 (IDU) 或出院或急诊科摘要上有丙型肝炎指征而住院的成年住院患者和急诊科就诊者。数据来源：医院入院、病理学、医院药房和门诊。我们评估了检测链的进展，并对丙型肝炎护理的预测因素（包括检测和治疗）进行了逻辑回归分析。在 79923 名成年患者中，有 1345 例（1.7%）有 IDU 编码的分离，628 例（0.8%）有丙型肝炎编码的分离（N=1892）。在研究结束时，1569 例（82.9%）患者的丙型肝炎病毒 (HCV) 状态未知。ED 入院与未提供丙型肝炎护理的可能性增加相关（比值比 3.29，95%置信区间 2.42-4.48）。尽管我们医院的住院患者中有超过 2%有检测指征，但大多数患者并未接受检测，尽管他们有住院接触。随着我们在本地区努力实现丙型肝炎消除，我们需要在感染风险较高的医院科室中纳入检测和联系策略。
