IS ONLY REQUESTING AN ANTI-HCV TEST SUFFICIENT FOR HEPATITIS C SCREENING?

Öz

Objective: Unless treated, a hepatitis C virus (HCV) infection is associated with high morbidity and mortality. The study investigates anti-HCV screening efficacy and treatment access rates for patients. Material and Method: This cross-sectional study screened all anti-HCV tests requested between January 2014-June 2017 from hospital records. Patient interviews were conducted by telephone-based interview. Result: The overall number of anti-HCV tests requested was 77,783, 1,373 of which were positive. Among these, the study interviewed 488 patients (266 females, 222 males; mean age=52.81±16.5 years) and analyzed their tests. Further investigation with HCV-RNA had not been done in 69 (14.1%) anti-HCV positive patients. HCV-RNA was positive in 309 patients, 268 of whom were treated (86%), while 41 were not (14%). The main reasons for remaining untreated are: unknown (21%), no patient follow up (28%), or physician didn’t indicate (19%). Conclusion: In order to successfully eliminate HCV, the anti-HCV test alone is not enough. Informing patients about the results of the anti-HCV test and, if positive, referring them for the HCV-RNA test are important. When considering the high amount of untreated patients, linkage to care should be encouraged in HCV-RNA positive patients unless an absolute contraindication is present.

Anahtar Kelimeler

• Hepatitis C virus infection
• anti-HCV antibody
• HCVRNA
• screening

HEPATİT C TARAMASI İÇİN SADECE ANTİ-HCV TESTİ İSTEMEK YETERLİ MİDİR?

Öz

Amaç: HCV enfeksiyonu, tedavi edilmediği sürece yüksek morbidite ve mortalite ile ilişkilidir. Bu çalışmada anti-HCV tarama etkinliği ve tedaviye erişim oranları araştırılmıştır. Gereç ve Yöntem: Bu kesitsel çalışmada Ocak 2014 ile Haziran 2017 tarihleri arasında istenen tüm anti-HCV testleri hastane kayıtlarından tarandı. Hasta görüşmeleri yüz yüze veya telefon ortamında yapıldı. Bulgular: İstenilen toplam anti-HCV testi sayısı 77783 olup, bunların 1373'ü pozitif çıkmıştır. Bunlardan 266'sı kadın, 222'si erkek; yaş ortalaması 52,81±16,5 yıl olan 488 hastayla görüşme yapılmıştır. Anti-HCV pozitif hastaların 69'una (%14,1) HCV-RNA ile ileri araştırma yapılmadığı saptandı. 309 hastada HCV-RNA pozitifti ve 268'i tedavi almışken (%86), 41'i (%14) tedavi edilmemişti. Tedavisiz kalmanın temel nedenleri ise bilinmeyen (%21), takip edilmeyen hasta (%28) ve hekimin endikasyon göstermemesi (%19) olarak belirlendi. Sonuç: HCV'nin başarılı bir şekilde eradike edilmesi için anti-anti-HCV testi tek başına yeterli değildir. Hastaların anti-HCV testi sonuçları hakkında bilgilendirilmesi; pozitif ise HCV-RNA testine başvurulması önemlidir. Tedavi edilmeyen hasta sayısının yüksek olduğu göz önüne alındığında, mutlak bir kontrendikasyon olmadığı sürece HCV-RNA pozitif hastalarda tedaviye yönlendirilme teşvik edilmelidir.

Anahtar Kelimeler

• Hepatit C enfeksiyonu
• anti-HCV antikoru
• HCV RNA
• tarama

Kaynakça

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