Using a surveillance system to identify and treat newly acquired hepatitis C infection

December 1, 2008

http://www3.interscience.wiley.com/journal/121425940/abstract

Journal of Gastroenterology and Hepatology

Volume 23 Issue 12, Pages 1891 - 1894

Published Online: 29 Sep 2008

HEPATOLOGY

Using a surveillance system to identify and treat newly acquired hepatitis C

infection

Nick Walsh,*,† Lim*,† and Margaret Hellard*,†

*Department of Epidemiology and Preventive Medicine, Monash University, Alfred

Hospital, Melbourne, and † Macfarlane Burnet Institute for Medical Research

and Public Health, Melbourne, , Australia

Correspondence to Dr Nick Walsh, c/o Addiction Medicine Unit, Dandenong

Hospital, Street, Dandenong, Vic., 3175, Australia. Email:

nicktropical@...

Statements of contribution: Nick Walsh conceived the article, wrote the first

draft, contributed to data analysis, and coordinated and wrote the final review.

Lim conducted hepatitis C virus (HCV) surveillance, performed the data

analysis, and contributed to the manuscript. Margaret Hellard was instrumental

in developing the current system of follow-up of acute HCV cases in and

continues to provide technical advice in regards to the HCV surveillance system.

She was involved in conceiving the article and contributed to the manuscript.

Journal of Gastroenterology and Hepatology Foundation

ABSTRACT

Background and Aim: Hepatitis C treatment uptake in Australia is low. We

describe the rate of acute hepatitis C treatment in the Australian state of

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.

Conclusion: 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.

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Accepted for publication 14 April 2008.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1440-1746.2008.05508

December 1, 2008