Akademik Veri Yönetim Sistemi
Mikrobiyoloji Bulteni, cilt.59, sa.2, ss.191-202, 2025 (SCI-Expanded)
With the availability of effective treatments today, HCV elimination has become possible. The study aimed to raise awareness about increasing micro-elimination strategies towards achieving global elimination by communicating with existing anti-HCV positive cases through the Hospital Information Management System (HIMS) used in health institutions and to complete the diagnosis and treatment process of the cases. Patients over 18 identified as anti-HCV positive in our hospital’s HIMS system between January 2013 and January 2022 were included in the study. The study was conducted retrospectively and prospectively. Electronic medical records were reviewed to determine whether HCV RNA testing had been performed, whether treatment had been administered and which departments had ordered the tests. Patients without HCV RNA test results or treatment records were contacted and informed by a competent physician via phone. These patients were invited to the hospital to complete the diagnosis and treatment process. Those meeting treatment criteria among the patients who presented to the hospital were treated with direct-acting antiviral (DAA) therapy. The anti-HCV seropositivity rate was detected in 1658 patients (1.38%). Among the anti-HCV seropositive cases, 1282 (77.3%) had undergone HCV RNA testing, while 376 (22.7%) had not. Patients without HCV RNA testing were determined to be older (mean age 64 vs. 53 years, p< 0.001). A significant proportion of cases without HCV RNA test requests belonged to the unrelated medical specialties (74.5% vs. 25.5%, p< 0.001). Among the cases that underwent HCV RNA testing, positive results were found in 741 patients (58%). It was determined that 494 patients (66.2%) had a treatment record in our hospital. Of those treated, 66 patients (13%) received pegylated interferon-based therapy, while 428 (86.6%) received DAA therapy. Telephone contact was established with 150 cases (39.9%) who did not have HCV RNA testing and it was understood that 37 cases (24.7%) were unaware of their status. It was determined that a total of 59 (39.3%) cases visited our outpatient clinic.Fourteen of the patients (23.7%) were diagnosed with chronic hepatitis C and were offered treatment. Two patients declined treatment, while 12 were treated with DAA drugs, achieving a cure in all cases. Some of the anti-HCV positive individuals included in the HIMS of healthcare providers remain in the system as “missing patients” before the diagnosis and treatment processes are completed. As soon as these patients are identified, especially in requests made by non-hepatitis-related specialties and in individuals over the age of 60, reflex test protocols and HCV RNA analyses should be performed and alert systems should be established to direct these patients to the relevant specialties. Re-establishing contact with missing patients and completing the diagnosis and treatment processes is of great importance for both individual health gain and public health. This strategy is an important step towards the HCV microelimination and will ultimately contribute significantly to achieving the global elimination goal.