439. Innovative Linkage to Care for Patients with Hepatitis C Virus Infection
Session: Poster Abstract Session: Hepatitis C
Thursday, October 27, 2016
Room: Poster Hall

Background: UCLA Health is a complex healthcare system with over 150 offices in Southern California. The main cause for liver transplant at UCLA is chronic hepatitis C virus (HCV) infection. As new and more effective medications become available, it is important to screen patients and link them to care in a timely manner. A hepatitis C linkage to care coordinator was introduced in January 2016 to facilitate evaluation and treatment for patients diagnosed with hepatitis C infection.

Methods: The UCLA Laboratory provided a weekly list of all patients tested to the HCV linkage to care coordinator. Ordering physicians were notified by the HCV care coordinator via the electronic medical record system if their patient tested positive for the HCV antibody. The HCV care coordinator recommended HCV Quant Reflex to Genotype and Prometheus FibroSpect II testing. The HCV care coordinator worked with the ordering physician to facilitate a visit for the patient to hepatology or infectious disease specialists. We compared the time to evaluation in December 2015 (prior to HCV care coordinator) and April 2016 (after HCV care coordinator).

Results: In December 2015, 31 individuals tested positive for the HCV antibody, 25 were new HCV antibody positive and 23 received the HCV RNA confirmatory test. Of those, 11 were HCV RNA positive and linked to care with an average time to evaluation of 38.6 days. In April 2016, 76 individuals tested positive for the HCV antibody, 18 were new HCV antibody positive and 17 received the HCV RNA confirmatory test. Of those, 6 were HCV RNA positive and 5 were linked to care with an average time to evaluation of 14.7 days. Between January 2016 and April 2016, 280 individuals tested positive for the HCV antibody, 24% (67/280) were new HCV antibody positive and 88% (59/67) received the HCV RNA confirmatory test. Of those, 36% (21/59) were HCV RNA positive and 90% (19/21) were linked to care.

Conclusion: Implementation of the HCV linkage to care coordinator reduced time to evaluation for patients with HCV infection. Further evaluation of the impact of HCV care coordination on treatment initiation is ongoing.

Figure 1. Linkage to care cascade for Anti-HCV positive patients between January 2016 and April 2016.

Mariana Castrejon, BS1, Samantha Ramirez, RN2, Jeffrey Klausner, MD, MPH1, Marjan Javanbakht, MPH, PhD3 and Sammy Saab, MD, MPH4, (1)Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, (2)Transplant Services Nursing, UCLA, Los Angeles, CA, (3)Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, (4)Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA

Disclosures:

M. Castrejon, None

S. Ramirez, None

J. Klausner, Gilead Sciences: Investigator , Research support

M. Javanbakht, None

S. Saab, None

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