Hepatitis C virus-free endoscope procedures project: An in-hospital elimination approach.

The Kaohsiung journal of medical sciences Pub Date : 2025-03-01 Epub Date: 2025-01-16 DOI:10.1002/kjm2.12942
Benjamin Lih-Ren Hsieh, Yen-Ting Kuo, Yu-Ju Wei, Pei-Chien Tsai, Ming-Lun Yeh, Chung-Feng Huang, Chia-Yen Dai, Ming-Yen Hsieh, Jee-Fu Huang, Ming-Lung Yu, Wan-Long Chuang
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Abstract

Hepatitis C virus (HCV) elimination in the care cascades for patients receiving invasive procedures remains elusive. This study aimed to evaluate the efficacy of HCV-free Endoscope Procedures Project (CEPP) in the effort toward hospital HCV micro-elimination in Taiwan. An electronic medical record (EMR)-based remind system was introduced into gastrointestinal, surgical, urological, and gynecological departments prior to the endoscopy procedures. Anti-HCV tests were actively ordered on their EMR among those patients who have not been tested in the past 5 years. Those patients with anti-HCV+ were recruited into the care cascade for HCV treatment, including HCVRNA testing, direct antivirals (DAAs) delivery, and treatment response assessment. We divided the elimination project into two phases: before (2020 Jan to 2020 Dec, phase A) and during (2021 Jan to 2022 Sep, phase B) the remind system. The screening rate of phase B was 64.2% (1857/2893), which was significantly higher than phase A (18.7%, 899/4812) (p < 0.001). The screening rate of Department of Medicine (DOM) significantly increased from 21.1% of phase A to 89.3% of Phase B (p < 0.001). During phase B, the screening rate of non-DOM was 48.2%, which was significantly higher than 11.8% of Phase A (p < 0.001). During Phase B, 15 (0.8%) out of 1857 screened patients were HCVRNA+. Six HCVRNA+ patients received DAAs treatment, and all achieved viral eradication. The CEPP significantly increased the anti-HCV screening rate for subsequent care cascades, particularly in patients of DOM.

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无丙型肝炎内窥镜程序项目:一种院内消除方法。
在接受侵入性手术的患者的护理级联中消除丙型肝炎病毒(HCV)仍然难以捉摸。在内窥镜检查之前,在胃肠道、外科、泌尿科和妇科引入了基于电子病历(EMR)的提醒系统。在过去5年未做过抗- hcv检测的患者中,在他们的电子病历中积极要求进行抗- hcv检测。这些抗-HCV+患者被纳入HCV治疗的护理级联,包括HCVRNA检测、直接抗病毒药物(DAAs)递送和治疗反应评估。我们将淘汰项目分为两个阶段:提醒系统之前(2020年1月至2020年12月)和提醒系统期间(2021年1月至2022年9月)。B期筛查率为64.2%(1857/2893),显著高于A期(18.7%,899/4812)
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