Using a surveillance system to identify and treat newly acquired hepatitis C infection

J Gastroenterol Hepatol. 2008 Dec;23(12):1891-4. doi: 10.1111/j.1440-1746.2008.05508.x.

Abstract

Background and aim: Hepatitis C treatment uptake in Australia is low. We describe the rate of acute hepatitis C treatment in the Australian state of Victoria by linking the centralized passive notifications system for hepatitis C with the Australian Trial in Acute Hepatitis C (ATAHC), a nationwide clinical trial aimed at providing people with newly acquired hepatitis C with 24 weeks' pegylated interferon monotherapy.

Methods: Mandatory notifications of clinical or laboratory evidence of hepatitis C were further investigated for evidence of newly acquired infection. Followed-up individuals were then screened for eligibility for the ATAHC study (which included documented hepatitis C antibody positivity within the previous 6 months) and offered acute hepatitis C treatment if this was the case. We examined the first 18 months of the recruitment.

Results: A total of 4591 hepatitis C cases were notified with 414 (9%) of these flagged as being potentially newly acquired. Through follow-up of doctors and patients, 160 of these were confirmed as newly acquired; 87 of these 160 (54%) were potentially eligible for ATAHC and were referred to ATAHC researchers. Fourteen (16%) were successfully enrolled in ATAHC. Eight individuals commenced acute hepatitis C treatment during this period.

Conclusion: The use of hepatitis C surveillance system has been successful in identifying cases of newly acquired hepatitis C which are often difficult to identify in a clinical setting. In addition, marginalized patients who may otherwise never have been referred to a clinic are able to access hepatitis C treatment and specialist services. Despite this, only eight out of 87 eligible individuals (9%) began acute hepatitis C treatment.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Antiviral Agents / therapeutic use*
  • Disease Notification / methods*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility*
  • Hepatitis C / diagnosis*
  • Hepatitis C / drug therapy*
  • Hepatitis C / epidemiology
  • Humans
  • Interferons / therapeutic use*
  • Male
  • Patient Dropouts
  • Patient Selection
  • Population Surveillance
  • Program Evaluation
  • Substance Abuse, Intravenous / epidemiology
  • Time Factors
  • Treatment Refusal
  • Victoria / epidemiology
  • Young Adult

Substances

  • Antiviral Agents
  • Interferons