Enhanced surveillance for hepatitis B and C: insights into clinical care after diagnosis
DOI:
https://doi.org/10.33321/cdi.2026.50.047Keywords:
hepatitis B, hepatitis C, linkage to care, surveillance, antiviral treatmentAbstract
Background
There are known gaps in care uptake for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and public health surveillance represents an opportunity to support health service engagement for cases; however, specific data are lacking regarding follow-up after diagnosis. We assessed outcomes of a Victorian initiative to enhance data availability and to support linkage to care.
Methods
Notified cases of HBV and HCV within Victoria during 2023–2024 were analysed to determine post-diagnosis follow-up, including variation by demographics and setting, and reported reasons for lack of linkage to care.
Results
Information was available for two-thirds of cases. For HBV, 37.7% reported current treatment or management, while 53.6% reported referral or assessment in progress; for HCV, these proportions were 33.3% and 54.7%. Reasons for gaps included loss to follow-up, cost barriers, and misapplication of HBV treatment criteria.
Discussion
Cascade of care information can be effectively collected via public health surveillance, and these systems represent an opportunity to support prioritisation of public health follow-up.
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References
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