In-Hospital Hepatitis C Virus Alarm System: A Strategy to Improve Linkage to Care for HCV.

Background/Aims World Health Organization has set a goal to end the endemic of viral hepatitis C by 2030. Increasing linkage to care and treatment success for HCV patient is essential. Daegu Catholic University Medical Center introduced an in-hospital HCV alarm system on July 6, 2022, to notify the responsible physician of HCV antibody detection. This study aims to evaluate the effectiveness of this alarm system in improving linkage to care for hepatitis C. Methods This is a retrospective study using electronic medical records of DCUMC for each patient screened for HCV between September 2020 and May 2024. Linkage is defined as referring a HCV Ab detected patient to a hepatologist. We compared the differences in RNA test implementation rates and linkage success rates before and after the alarm system. We evaluated factors associated with RNA testing failure, using logistic regression analysis. Results Before and after the alarm system, 24,713 and 25,498 patients were screened respectively. HCV antibodies were detected in 446 (1.8%) and 479 (1.9%) patients. Among the HCV Ab detected patients, 260 (58.3%) and 338 (70.6%) completed HCV RNA testing (p<0.001). Linkage was 278 (62.3%) and 377 (78.7%), respectively (p <0.001). These factors were associated with RNA testing failure; patient’s department; surgical department (OR, 3.63; 95% CI, 2.43-5.42); emergency medicine (OR, 2.18; 95% CI, 1.36-3.47); without alarm (OR, 1.96; 95% CI, 1.42-2.70). Conclusion The implementation of the in-hospital HCV alarm system not only encourages HCV RNA testing for HCV Ab detected patients but also improves their linkage to hepatologists. Additionally, HCV RNA testing failures are more likely to occur in surgical and emergency departments than in medical departments. These suggest that the alarm system, along with the cooperation of surgical and emergency medical doctors, is essential to improve linkage to care. [ABSTRACT FROM AUTHOR]