EFFECTIVE RE-ENGAGEMENT OF HEPATITIS C PATIENTS: A MULTICENTER STUDY BASED ON LABORATORY RECORDS IN ARGENTINA

Introduction and Objectives

Hepatitis C virus (HCV) remains a significant cause of global morbidity despite the availability of highly effective direct-acting antivirals (DAAs). In Argentina, fragmented healthcare access and a high prevalence of advanced liver disease underscore the need for re-engagement strategies to achieve HCV elimination. This study aimed to assess the effectiveness of a multicenter re-engagement program for HCV patients lost to follow-up in high-complexity healthcare settings.

Materials and Methods

A multicenter prospective study (March–November 2024) analyzed blood samples from five hospitals to identify HCV antibody-positive patients. Positive cases were contacted to confirm viremia, undergo clinical evaluation, and initiate treatment. Data collected included re-engagement rates, fibrosis staging (FibroScan), genotype distribution, treatment regimens, and sustained virologic response (SVR) rates. Chi-square tests were used to compare positivity rates, genotype distribution, and treatment regimens.

Results

Among 206,053 samples, 3,334 (1.62%) tested positive for HCV antibodies, and 2,149 (64.5%) were potentially eligible for re-engagement. Non-re-engagement causes included deaths (419), previous cure (741), and liver transplants (25). Positive cases were 54.16% male (p = 0.03). A total of 422 patients (19.6%) were successfully re-engaged, of whom 311 (73.8%) exhibited advanced fibrosis (≥F2). Genotype 3 prevalence was similar to others (p = 0.3). Among re-engaged patients, 167 initiated treatment with Sofosbuvir/Velpatasvir (70.08%), Glecaprevir/Pibrentasvir (29.92%) (p = 0.12). Overall SVR12 rate was 97.98% among treated patients. SVR4 was assessed in 112 patients, showing a 100% correlation with SVR12.

Conclusions

This program successfully re-engaged HCV patients lost to follow-up, achieving high SVR12 rates and demonstrating the utility of SVR4 as an early predictor. A significant proportion of patients were unaware of their diagnosis, available treatments, or disease progression. The majority of treated patients had advanced fibrosis, highlighting the need for proactive strategies targeting high-risk populations. These findings underscore the necessity of establishing elimination programs in countries with complex healthcare systems like Argentina.

Conflict of interest: Yes, GILEAD SCIENCES