Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34756
Title: Broadening and strengthening the health providers caring for patients with chronic hepatitis C may improve continuity of care.
Austin Authors: Clark, Paul J;Valery, Patricia C;Strasser, Simone I;Weltman, Martin;Thompson, Alex;Levy, Miriam T;Leggett, Barbara;Zekry, Amany;Rong, Julian;Sinclair, Marie ;George, Jacob;Bollipo, Steven;McGarity, Bruce;Sievert, William;MacQuillan, Gerry;Tse, Edmund;Nicoll, Amanda;Wade, Amanda;Cheng, Wendy;Roberts, Stuart K
Affiliation: Department of Gastroenterology, Princess Alexandra and Mater Hospitals, and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
QIMR Berghofer Medical Research Institute, and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Hepatology Services, Nepean Hospital, Penrith, New South Wales, Australia.
Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia.
USYD, Department of Gastroenterology and Liver, Liverpool Hospital, Sydney, New South Wales, Australia.
Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital and Faculty of Medicine, Brisbane, Queensland, Australia.
Department of Gastroenterology and Hepatology, St George Hospital, Sydney, New South Wales, Australia.
Gippsland Gastroenterology, Latrobe Regional Hospital, Traralgon, Victoria, 3844, Australia.
Gastroenterology and Hepatology
Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia.;Storr Liver Unit, Westmead Hospital, Westmead, New South Wales, Australia.
Gastroenterology Department, John Hunter Hospital, New Lambton, New South Wales, Australia.;Gastroenterology Department, John Hunter Hospital, Newcastle and School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia.
Bathurst Liver Clinic Bathurst Hospital, Bathurst, New South Wales, Australia.
Gastrointestinal and Liver Unit, Monash Health and Monash University, Melbourne, Victoria, Australia.
Department of Hepatology and Liver Transplant Unit, Sir Charles Gairdner Hospital, Nedlands, West Australia, Australia.
Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Eastern Health, Box Hill, Victoria, Australia.
Burnet Institute, Melbourne, Victoria, Australia.;Barwon Health Liver Clinic University Hospital, Geelong, Victoria, Australia.
Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, West Australia, Australia.
The Alfred Hospital, Melbourne, Victoria, Australia.
Issue Date: 19-Dec-2023
Date: 2023
Publication information: Journal of Gastroenterology and Hepatology 2023-12-19
Abstract: Direct-acting antiviral (DAA) therapies for hepatitis C virus infection (HCV) lead to excellent rates of sustained virological response (SVR). However, loss to follow-up (LTFU) for SVR testing remains a challenge. We examine factors associated with LTFU in a real-world setting. Adults who received DAA therapy for HCV in one of 26 centers across Australia during 2016-2021 were followed up for 2 years. Data sources included the patient medical records and the national Pharmaceutical and Medicare Benefits Schemes. Linkage to Medicare provided utilization data of other health-care providers and re-treatment with DAAs. LTFU was defined as no clinic attendance for SVR testing by at least 52 weeks after DAA treatment commencement. Multivariable logistic regression assessed factors associated with LTFU. In 3619 patients included in the study (mean age 52.0 years; SD = 10.5), 33.6% had cirrhosis (69.4% Child-Pugh class B/C), and 19.3% had HCV treatment prior to the DAA era. Five hundred and fifteen patients (14.2%) were LTFU. HCV treatment initiation in 2017 or later (adj-OR = 2.82, 95% confidence interval [CI] 2.25-3.54), younger age (adj-OR = 2.63, 95% CI 1.80-3.84), Indigenous identification (adj-OR = 1.99, 95% CI 1.23-3.21), current injection drug use or opioid replacement therapy (adj-OR = 1.66, 95% CI 1.25-2.20), depression treatment (adj-OR = 1.49, 95% CI 1.17-1.90), and male gender (adj-OR = 1.31, 95% CI 1.04-1.66) were associated with LTFU. These findings stress the importance of strengthening the network of providers caring for patients with HCV. In particular, services targeting vulnerable groups of patients such as First Nations Peoples, youth health, and those with addiction and mental health disorders should be equipped to treat HCV.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34756
DOI: 10.1111/jgh.16440
ORCID: 0000-0002-8823-3006
0000-0001-7829-0974
0000-0002-9015-7997
Journal: Journal of Gastroenterology and Hepatology
PubMed URL: 38114452
ISSN: 1440-1746
Type: Journal Article
Subjects: Cirrhosis
Depression
Direct-acting antiviral
Fibrosis-4 scores
Hepatitis c virus
Injection drug use
Liver disease
Liver fibrosis
Loss to follow-up
Sustained viral response
Appears in Collections:Journal articles

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