Treatment Outcomes of Hepatitis C Using the Test and Treat Service Model at Chaiyaphum Hospital

Abstract

Background and Methods: The objective of this study is to determine the prevalence of Hepatitis C Virus (HCV) infection among a cohort of 7,075 individuals in Mueang District, Chaiyaphum Province, Thailand, in 2024. Furthermore, the study will conduct a comparative analysis of treatment outcomes between the conventional treatment regimen implemented in 2023 and the novel Test and Treat approach initiated in 2024 among HCV patients treated at Chaiyaphum Hospital. Data will be analyzed using descriptive statistics, t-test, Kaplan-Meier survival analysis, incidence risk difference, and incidence rate ratio.

Results: Screening efforts exceeded the target by approximately twofold, identifying 7,075 individuals. HCV prevalence was relatively low at 2.5%. The screening process identified shared use of items as the major risk factor, accounting for 15.6% of cases. However, data loss was a concern, particularly for laboratory results and personal information. Under the traditional approach, 15.16 out of 100 person-months achieved treatment success, with an average treatment duration of 5.30 months. In contrast, the Test and Treat group achieved a higher success rate of 23.77 per 100 person-months, with a shorter average treatment duration of 3.63 months. The Test and Treat group had a significantly higher success rate (incidence rate diff.: 8.6; 95% CI: 0.5, 16.7; risk ratio: 1.57; 95% CI: 1.02, 2.41; p-value = 0.031). However, when comparing the time from initiating treatment to completion, there was no significant difference in treatment success (incidence rate diff.: 2.56; 95% CI: -9.40, 14.52; risk ratio: 1.09; 0.71, 1.67). The most significant difference between the two approaches was the treatment duration, with the Test and Treat group completing treatment 1.67 months earlier (Mean diff. = 1.67; 95% CI: 1.03, 2.31).

Conclusion: The study demonstrated the successful implementation of a large-scale HCV screening program, exceeding targets and identifying a low prevalence of HCV. The Test and Treat strategy showed promise in improving access to treatment and reducing treatment duration. However, data quality issues, the need for community engagement, and ongoing improvements in treatment protocols and healthcare workforce capacity remain critical areas for future research and intervention.