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Revista Uruguaya de Medicina Interna
On-line version ISSN 2393-6797
Abstract
OTEGUI, Juan; OLIVARI, Daniela; MAINARDI, Victoria and GERONA, Solange. Implementation of a strategy of reconnection to care in patients with chronic infection by the hepatitis C virus in the Central Hospital of the Armed Forces of Uruguay. Preliminary results. Rev. Urug. Med. Int. [online]. 2022, vol.7, n.1, pp.27-35. Epub Mar 01, 2022. ISSN 2393-6797. https://doi.org/10.26445/07.01.3.
Introduction:
Chronic infection by the hepatitis C virus (HCV) is responsible for 400,000 deaths per year, mainly associated with the development of cirrhosis and hepatocellular carcinoma. The advent of new direct-acting antivirals has marked a turning point in the treatment of HCV, leading to almost 100% cure of treated patients. In this sense, the WHO has set as objectives for the year 2030, to reduce new HCV infections by 90% and the mortality associated with this virus by 65%, for which it is necessary to develop active strategies for diagnosis and linkage to care and treatment.
The objective of the work is to carry out a diagnosis of the situation of the patients infected by HCV in the Central Hospital of the Armed Forces (HCFFAA), and to implement and evaluate a sequential strategy of re-attachment to care.
Methodology:
The treatment cascade was constructed by estimating the number of patients with chronic HCV infection based on local prevalence and review of the medical records of patients seen in the Hepatology and Liver Transplant service of the HCFFAA. A strategy was implemented to contact patients with HCV infection sequentially, seeking to re-establish their link with the health service, ensuring access to liver disease staging and antiviral treatment.
Results:
The estimated global prevalence of people with chronic HCV infection was 1,008 people. Of 135 patients with positive serology, 113 had confirmatory RNA, 76 had received treatment, and 70 had achieved sustained virologic response. The implementation of the strategy achieved an increase in the prescription of treatment from 67% to 76% of patients with confirmed chronic HCV infection.
Conclusions:
The implementation of the rebinding strategy was successful, with an increase in the prescription of antiviral treatment in patients who are candidates for treatment. Active search for undiagnosed infected patients through screening is the next step to achieve eradication goals.
Keywords : Chronic HCV infection; screening; treatment cascade; re-linking to care.
