Open forum infectious diseases · 2026
Implementation of a Hepatitis C Screening Program for At-Risk Former Soviet-Bloc Immigrants in a Large Health Maintenance Organization.
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Rahamim-Cohen Daniella, Cohen Bar, Atias Dor, Nakhleh Afif, Liran Ori, Kaplan Lavi Izana, Azuri Joseph, Adler Limor, Ben David Shirley Shapiro
Аннотация
BACKGROUND: Hepatitis C virus (HCV) is a leading cause of liver disease worldwide. In 2021, Israel's Ministry of Health launched a national program to screen high-risk populations, especially immigrants from former Soviet Union countries, aiming to reduce HCV-related morbidity and mortality. This study evaluates the success of Maccabi Health Services (MHS) in implementing the screening program before and after the intervention, focusing on detection, treatment, and cure rates.
METHODS: A retrospective interrupted time-series cohort study was conducted among MHS members born in former Soviet Union countries, between 2019 and 2024. The intervention included proactive referrals for HCV antibody testing, educational messaging, and removal of bureaucratic barriers. Key outcomes were number of tests performed, positivity rates, polymerase chain reaction (PCR) confirmation, initiation of direct-acting antiviral treatment, and sustained virologic response (SVR).
RESULTS: Of 179 658 eligible members, 82.3% were screened after the intervention (compared to only 14.2% before). The rate of positive antibody tests dropped from 2.6% preintervention to 1%-1.1% postintervention. Ninety-three percent of antibody-positive individuals underwent PCR confirmation, with 52% testing positive. Eighty-four percent of PCR-positive patients started treatment, with higher initiation rates in the early intervention group. Sixty-nine percent of treated patients underwent SVR testing after treatment, with a median time of 106 days from treatment completion.
CONCLUSIONS: The proactive intervention by MHS led to a significant increase in screening coverage, detection, and treatment among the at-risk population. Removing barriers, providing education, and regular reminders were key to the program's success. This structured approach can serve as a model for screening programs in other populations and countries.
METHODS: A retrospective interrupted time-series cohort study was conducted among MHS members born in former Soviet Union countries, between 2019 and 2024. The intervention included proactive referrals for HCV antibody testing, educational messaging, and removal of bureaucratic barriers. Key outcomes were number of tests performed, positivity rates, polymerase chain reaction (PCR) confirmation, initiation of direct-acting antiviral treatment, and sustained virologic response (SVR).
RESULTS: Of 179 658 eligible members, 82.3% were screened after the intervention (compared to only 14.2% before). The rate of positive antibody tests dropped from 2.6% preintervention to 1%-1.1% postintervention. Ninety-three percent of antibody-positive individuals underwent PCR confirmation, with 52% testing positive. Eighty-four percent of PCR-positive patients started treatment, with higher initiation rates in the early intervention group. Sixty-nine percent of treated patients underwent SVR testing after treatment, with a median time of 106 days from treatment completion.
CONCLUSIONS: The proactive intervention by MHS led to a significant increase in screening coverage, detection, and treatment among the at-risk population. Removing barriers, providing education, and regular reminders were key to the program's success. This structured approach can serve as a model for screening programs in other populations and countries.