Evaluation of HCV-RNA results in cases with anti-HCV

In this study, it was aimed to determine the HCV-RNA request rate and positivity in patients with anti-HCV positivity, and to examine the current HCV-RNA levels of patients who were not tested for HCV-RNA after anti-HCV positivity was detected. In this prospective cohort study, patients who were tested for anti-HCV at Necmettin Erbakan University (NEU) Meram Medical Faculty Hospital between January 1, 2011 and December 31, 2020 were included. Among these cases, those who did not have HCV RNA were called for follow-up, and necessary tests and treatments were performed. The test results of 6.3% (n = 10.115) of 161.282 cases whose records were accessed were positive. The departments that most frequently requested anti-HCV tests were hepatology (8.9%) and obstetrics and gynecology 7.8%. 53.3% of the cases with anti-HCV positivity were male and the mean age was 55.12 ± 16.83 years. While 60.7% of the examinations were for screening purposes, 39.3% were preoperative examinations. It was observed that 74.0% (n = 7485) of the cases with anti-HCV positivity were positive for HCV RNA, and 3.4% (n = 342) were not tested for HCV RNA. After detecting positive anti-HCV, the departments that requested HCV RNA most frequently were 40.1% infectious diseases and 33.4% hepatology, while the most common departments that did not measure HCV RNA were 9.9% general surgery and 8.8% eye diseases. Of the tests not tested for HCV RNA, 58.8% were for screening purposes and 41.2% were for preoperative examination. As a result of HCV RNA analysis performed on 100 cases without HCV RNA, it was determined that 95% of the cases were negative and 5% were positive. Compared with those who were found to be HCV RNA negative at the current admission, the anti-HCV level at the first admission was statistically significantly higher in those with HCV RNA positivity (p<0.001). Non-cirrhotic liver was found in 4 of those with HCV RNA positivity, and coarsening of the liver parenchyma was observed in 1 patient. In conclusion, our study highlights that there are important shortcomings in the referral of patients with anti-HCV positivity for further examination and treatment by the relevant physicians. Intensive screening for chronic hepatitis C and greater access to direct-acting antivirals are needed. Key words: hepatitis C virus, prevalence, screening, treatment, awareness