Publication date: Feb 06, 2025

Disrupted linkage to care is a major barrier to hepatitis C virus (HCV) elimination leading to high attrition rates. This study aimed to describe (1) flow through the HCV care-cascade (2009-2020), and (2) monthly patterns in HCV care during the coronavirus disease 2019 (COVID-19) pandemic (2020) in Israel. Data were obtained from Maccabi Healthcare Services, a 2. 6-million-member healthcare provider in Israel. Flow through the HCV care-cascade in 2009-2020 was described from individuals’ first positive HCV antibody (Ab+) test to sustained virological response (SVR), and monthly data were obtained on individuals newly attaining a given stage in the HCV care-cascade in 2020. Among 2809 new patients who were Ab+, 2651 (94. 4%) had an HCV polymerase chain reaction (PCR) test, and 1417 (50. 4%) were PCR+ during the study. Median time from Ab+ to PCR+ was 3. 9 years, with 39. 7% PCR+ within 12 months. Median time from PCR+ to HCV treatment was 3. 3 years, with 639 (55. 5%) of patients who were PCR+ purchasing direct-acting anti-viral agents (DAAs), and 413/416 patients attained SVR. A significant reduction was observed in the time from first HCV detection (Ab+) to HCV confirmation (PCR+) and from PCR+ test to HCV treatment purchase in the pre-DAA era compared to the post-DAA. Monthly data during 2020 (Part B) indicates a decline in the numbers of patients receiving HCV care during the first pandemic-related closure. Real-world data from a nationally representative healthcare provider database suggest that HCV linkage to care improved over time alongside increased access to DAAs, despite observed declines in access to care in 2020.

Open Access PDF

Semantics

Original Article