Active follow-up of hepatitis C notifications by public health staff improves treatment uptake

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health Pub Date : 2025-09-11 DOI:10.1016/j.anzjph.2025.100272

Siddhanth Sharma, Erica Parker, Kane Farmer, Benjamin Scalley

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引用次数: 0

Abstract

Objective

Improve hepatitis C treatment uptake in Perth, Western Australia, by piloting active follow-up of hepatitis C notifications, and evaluate the cost-effectiveness of this intervention.

Methods

Hepatitis C cases notified January to December 2023 (n=714) were reviewed. For each case, ribonucleic acid (RNA) testing status and direct-acting antiviral (DAA) treatment commencement status were assessed under the standard of care (pre-intervention baseline). Subsequently, an active follow-up intervention provided direct support to clinicians and patients to actively link patients to RNA testing and/or DAA commencement. Outcomes were then compared pre- and post-intervention, and the cost-benefit was estimated using conservative assumptions.

Results

Active follow-up increased RNA testing rates from 80% to 92% (p<0.01), resulting in an increase from 69% to 80% (p<0.01) of cases appropriately managed (i.e. commenced treatment or confirmed RNA negative). Twenty-two people were assisted to start treatment, costing $3,500 dollars per QALY gained, with a net societal benefit of $151,000.

Conclusions

Public health units can play an important role in tracking and sustaining momentum towards hepatitis C elimination. Active follow-up of notified cases is highly cost-effective.

Implications for Public Health

Hepatitis C treatment uptake has declined in recent years and remains below levels required for elimination in Australia by 2030. Actively managing notified cases can boost treatment uptake.

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公共卫生工作人员对丙型肝炎通报进行积极随访，可提高治疗接受度

目的：通过对丙型肝炎通报的积极随访试点，提高西澳大利亚州珀斯丙型肝炎治疗的接受程度，并评估这种干预措施的成本效益。方法回顾性分析2023年1月至12月报告的丙型肝炎病例（n=714）。对于每个病例，在护理标准（干预前基线）下评估核糖核酸（RNA）检测状态和直接作用抗病毒（DAA）治疗开始状态。随后，积极的随访干预为临床医生和患者提供了直接支持，积极将患者与RNA检测和/或DAA启动联系起来。然后比较干预前和干预后的结果，并使用保守假设估计成本效益。结果积极随访将RNA检测率从80%提高到92% (p<0.01)，导致适当管理（即开始治疗或确认RNA阴性）的病例从69%增加到80% （p<0.01）。22人得到了帮助，开始接受治疗，每获得一个QALY花费3500美元，社会净效益为15.1万美元。结论公共卫生单位可以在跟踪和维持消除丙型肝炎的势头方面发挥重要作用。对通报病例进行积极随访具有很高的成本效益。对公共卫生的影响近年来，丙型肝炎治疗的接受程度有所下降，仍低于澳大利亚到2030年消除丙型肝炎所需的水平。积极管理通报病例可促进接受治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian and New Zealand Journal of Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.20

自引率

5.70%

发文量

121

审稿时长

6-12 weeks

期刊介绍： The Australian and New Zealand Journal of Public Health (ANZJPH) is concerned with public health issues. The research reported includes formal epidemiological inquiries into the correlates and causes of diseases and health-related behaviour, analyses of public policy affecting health and disease, and detailed studies of the cultures and social structures within which health and illness exist. The Journal is multidisciplinary and aims to publish methodologically sound research from any of the academic disciplines that constitute public health.