Using a surveillance system to identify and treat newly acquired hepatitis C infection.
OBJECTIVE
Hepatitis C treatment uptake in Australia is low. We describe the rate of acute hepatitis C treatment in the Australian state of Victoria by linking the centralized passive notifications system for hepatitis C with the Australian Trial in Acute Hepatitis C (ATAHC), a nationwide clinical trial aimed at providing people with newly acquired hepatitis C with 24 weeks' pegylated interferon monotherapy.


METHODS
Mandatory notifications of clinical or laboratory evidence of hepatitis C were further investigated for evidence of newly acquired infection. Followed-up individuals were then screened for eligibility for the ATAHC study (which included documented hepatitis C antibody positivity within the previous 6 months) and offered acute hepatitis C treatment if this was the case. We examined the first 18 months of the recruitment.


RESULTS
A total of 4591 hepatitis C cases were notified with 414 (9%) of these flagged as being potentially newly acquired. Through follow-up of doctors and patients, 160 of these were confirmed as newly acquired; 87 of these 160 (54%) were potentially eligible for ATAHC and were referred to ATAHC researchers. Fourteen (16%) were successfully enrolled in ATAHC. Eight individuals commenced acute hepatitis C treatment during this period.


CONCLUSIONS
The use of hepatitis C surveillance system has been successful in identifying cases of newly acquired hepatitis C which are often difficult to identify in a clinical setting. In addition, marginalized patients who may otherwise never have been referred to a clinic are able to access hepatitis C treatment and specialist services. Despite this, only eight out of 87 eligible individuals (9%) began acute hepatitis C treatment.
Walsh
Nick
N
Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Australia. nicktropical@yahoo.com
Lim
Megan
M
Hellard
Margaret
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D018563:Disease Notification / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D010352:Patient Dropouts; D018579:Patient Selection; D011159:Population Surveillance; D015397:Program Evaluation; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D013997:Time Factors; D016312:Treatment Refusal; D014739:Victoria / Q000453:epidemiology; D055815:Young Adult
D000998:Antiviral Agents; D007372:Interferons