A pilot project harnessing surveillance systems to support clinicians providing clinical care for people diagnosed with hepatitis C in Victoria, Australia, September 2021 to 31 March 2022

Author:

Abbott Mielle1234ORCID,MacLachlan Jennifer H423ORCID,Romero Nicole23,Matthews Nicole513,Higgins Nasra1,Lee Alvin61,Stoove Mark785ORCID,Marukutira Tafireyi85ORCID,Quinn Brendan1ORCID,Allard Nicole L23910ORCID,Cowie Benjamin C329111ORCID

Affiliation:

1. Victorian Government Department of Health, Melbourne, Australia

2. Department of Infectious Diseases, University of Melbourne, Melbourne, Australia

3. WHO Collaborating Centre for Viral Hepatitis at The Doherty Institute, Melbourne, Australia

4. These authors contributed equally to this work and share first authorship.

5. Public Health, Burnet Institute, Melbourne, Australia

6. Australian Centre for the Prevention of Cervical Cancer, Melbourne, Australia

7. Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia

8. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

9. These authors contributed equally to this work and share last authorship.

10. cohealth, Melbourne, Australia

11. Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia

Abstract

Background Active follow-up of chronic hepatitis C notifications to promote linkage to care is a promising strategy to support elimination. Aim This pilot study in Victoria, Australia, explored if the Department of Health could follow-up on hepatitis C cases through their diagnosing clinicians, to assess and support linkage to care and complete data missing from the notification. Methods For notifications received between 1 September 2021 and 31 March 2022 of unspecified hepatitis C cases (i.e. acquired > 24 months ago or of unknown duration), contact with diagnosing clinicians was attempted. Data were collected on risk exposures, clinical and demographic characteristics and follow-up care (i.e. HCV RNA test; referral or ascertainment of previous negative testing or treatment history). Reasons for unsuccessful doctor contact and gaps in care provision were investigated. Advice to clinicians on care and resources for clinical support were given on demand. Results Of 513 cases where information was sought, this was able to be obtained for 356 (69.4%). Reasons for unsuccessful contact included incomplete contact details or difficulties getting in touch across three attempts, particularly for hospital diagnoses. Among the 356 cases, 307 (86.2%) had received follow-up care. Patient-management resources were requested by 100 of 286 contacted diagnosing clinicians. Conclusions Most doctors successfully contacted had provided follow-up care. Missing contact information and the time taken to reach clinicians significantly impeded the feasibility of the intervention. Enhancing system automation, such as integration of laboratory results, could improve completeness of notifications and support further linkage to care where needed.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Reference36 articles.

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2. Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual surveillance report 2021: Hepatitis C. Sydney: The Kirby Institute, The University of New South Wales, 2021.

3. Cancer Council Australia. Roadmap to Liver Cancer Control in Australia. 2023.

4. Hepatitis C Virus Infection Consensus Statement Working Group. Australian recommendations for the management of hepatitis C virus infection: a consensus statement (June 2020). Melbourne: Gastroenterological Society of Australia; 2020.

5. MacLachlan J, Stewart S, Cowie B. Viral Hepatitis Mapping Project: Geographic diversity in chronic hepatitis B and C prevalence, management and treatment. National Report 2020. Darlinghurst, NSW, Australia; 2021.

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