The authors were interested in the hepatitis C virus (HCV) care continuum in patients receiving care at federally qualified health centres in Philadelphia, PA, where a testing and linkage to care program had been established. One of the centres served a homeless population, two served public housing residents, one served a majority Hispanic population and the fifth, a “test and treat” site, also provided HCV treatment to patients. The authors examined data from the electronic health records of patients tested for HCV antibody between 2012–2016 and calculated the percentage of patients across all nine steps of the HCV care continuum from diagnosis to cure. Of the 885 chronically-infected patients studied, 92.2% received their RNA-positive result, 82.7% were referred to an HCV provider, 69.4% were medically evaluated by the provider, 55.3% underwent liver disease staging, 15.0% initiated treatment, 12.0% completed treatment, 8.7% were assessed for sustained virologic response (SVR) and only 8.0% achieved SVR. The authors found that the test and treat site patients were significantly more likely to be medically evaluated (adjusted odds ratio [aOR] 2.76, 95%CI 1.82-4.17) and to undergo liver disease staging (aOR 1.92, 95%CI 1.02-2.86) than patients at the other four centres combined. Therefore in an urban setting in the US, over two-thirds of HCV-infected patients were linked to care but treatment uptake was low. Scaling up treatment services in HCV testing centres is critical to improving the HCV care continuum.
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