One-step diagnosis strategy together with multidisciplinary telematics referral perform an effective approach for identifying and treating patients with active Hepatitis C infection.

Abstract

INTRODUCTION AND OBJECTIVES\nImplementation of one-step strategy for diagnosis of active Hepatitis C virus (HCV) infection would encourage the early diagnosis and reduce the time to access antiviral treatments. The aim of this study was to evaluate the impact of HCV one-step diagnosis compared to the traditional two-step protocol in terms of the time required for patients to be seen by specialist and the time taken to start antiviral treatment.\n\n\nMATERIAL AND METHODS\nA comparative study was carried out to assess two diagnostic algorithms (one-step and two-step) for active HCV infection. Serological markers were quantified using the same serum sample to determine both anti-HCV antibodies (HCV-Ab) and HCV core antigen (HCV-cAg) by Architect i2000 SR kit. In this period, a multidisciplinary procedure was started for telematics referral of viremic patients.\n\n\nRESULTS\nOne-step approach reduced the time required for patient HCV diagnosis, referral to a specialist, access to treatment, and eliminated the loss of patients to follow-up. Significant differences were observed between one-step and two-step diagnosis methods in the time required for patients to be seen by specialist (18 days [Interquartile range (IQR)\u202f=\u202f14-42] versus 107 days [IQR\u202f=\u202f62-148]) and for the initiation of treatment (54 days [IQR\u202f=\u202f43-75] versus 200 days [IQR\u202f=\u202f116-388]), mainly for patients with advanced fibrosis (35 days [IQR\u202f=\u202f116-388] versus 126 days [IQR\u202f=\u202f152-366]).\n\n\nCONCLUSIONS\nUse of HCV-cAg has proven to be a useful tool for screening patients with active hepatitis C. The development of a multidisciplinary protocol for the communication of results improved the efficiency of the care process.