Background:

Hepatitis C is typically diagnosed by positive Anti-HCV (hepatitis C virus) antibodies. Direct acting antivirals (DAAs) are the gold standard for treatment, which act by inhibiting proteins for viral replication. Treatment with DAAs is highly efficacious, with a rate of cure >95%. With such an effective treatment available for Hepatitis C, it is paramount that patients are connected to care as soon as possible to prevent complications which include liver cirrhosis, hepatocellular carcinoma, and worsened outcomes for diabetes, cardiovascular disease, and chronic kidney disease.

Within LA county between 2017-2021, out of nearly 33,000 patients reported with Hep C infection, only an estimated 14,000 received treatment.

Objective:

This project seeks to investigate reasons why patients with a positive HCV antibody test did not receive treatment, with a goal of increasing linkage to care. 

Methods:

Using data from the LADPH database of patients with positive HCV antibody tests from 2017-2021, patients tested at Harbor UCLA were called to screen for past treatment. Patients identified to have not been treated were invited to answer a phone survey and responses recorded for qualitative analysis.

Results: 

Preliminary data suggests that patients that were aware of their positive HCV diagnosis declined treatment due not wanting to take an additional medication. For patients that were not aware of their positive test prior to our calls, many were open to receiving treatment. Additional phone calls are being made to connect with patients that we were unable to reach.

Conclusions:

Our preliminary findings suggest a care gap for patients that test positive for HCV but are unaware of their diagnosis and treatment options. Next steps include connecting with patients who have tested positive in the past, and improving follow up within the current testing protocol to ensure awareness of positive diagnoses and invitation to receive DAA treatment.