Micro-Elimination of Hepatitis C among Patients with Kidney Disease by Using Electronic Reminder System—A Hospital-Based Experience

Abstract

Background: Little is known about the use of an electronic reminder system for HCV screening among patients with kidney disease. In this study, we tried to determine whether reminder systems could improve the HCV screening rate in patients with kidney disease. Methods: Patients with kidney disease were enrolled from August 2019 to December 2020 to automatically screen and order HCV antibody and RNA testing in outpatient departments. Results: A total of 19,316 outpatients with kidney disease were included, and the mean age was 66.5 years. The assessment rate of HCV antibody increased from 53.1% prior to the reminder system to 79.8% after the reminder system (p < 0.001), and the assessment rate of HCV RNA increased from 71% to 82.9%. The anti-HCV seropositivity rate decreased from 7.3% at baseline to 2.5% after the implementation of the reminder system (p < 0.001), and the percentage of patients with detectable HCV RNA among those with anti-HCV seropositivity decreased from 69.1% at baseline to 46.8% (p < 0.001). Conclusions: The feasibility of an electronic reminder system for HCV screening among patients with kidney disease in a hospital-based setting was demonstrated.

Pan-Genotypic Direct-Acting Antiviral Agents for Undetermined or Mixed-Genotype Hepatitis C Infection: A Real-World Multi-Center Effectiveness Analysis

“…To achieve the goal set by the World Health Organization for HCV elimination, a diagnostic rate of 90% and a treatment coverage rate of 80% are required to achieve a 65% reduction in the rate of HCV-related deaths by 2030 [ 4 , 10 , 34 , 35 , 37 ]. A major challenge is determining the HCV genotype before initiating DAA regimens.…”

“…Chronic hepatitis C virus (HCV) infection is one of the common causes of liver cirrhosis and liver cancer that can now be prevented by effective antiviral therapy [ 1 , 2 , 3 , 4 , 5 , 6 ]. Over the past two decades, interferon-based therapy was the standard of care; however, its use is limited to numerous treatment-related side effects, the risk of liver decompensation among cirrhotic patients, and the need to understand the genotype of HCV to determine the treatment duration.…”

“…These agents have been reimbursed in Taiwan since 2017, and the government of Taiwan has set the goal of obtaining an 80% treatment coverage rate with DAAs by 2025 [ 1 , 7 , 8 , 9 ]. There are still several barriers to HCV elimination, such as the limitation of patient access to therapy, insufficient knowledge of HCV therapy, lack of awareness of the disease, and the complexity of treatment [ 4 , 10 , 11 , 12 ].…”