A telephone intervention to re-engage patients with positive hepatitis C antibody tests at an academic medical center

<h2>Abstract</h2><h3>Background</h3> A hepatitis C virus (HCV) microelimination project at our institution identified a substanial number of patients who tested positive for HCV antibodies (Abs) without subsequent confirmatory HCV RNA testing. <h3>Objectives</h3> The objectives of this study were to (1) implement a telephone intervention to re-engage patients with positive HCV Ab results and (2) assess patients' understanding of HCV disease progression, testing, and treatment. <h3>Methods</h3> Patients were eligible for study inclusion if they were aged 18 years and older and had a positive HCV Ab test without documented confirmatory HCV RNA testing between January 2019 and December 2020. Eligible patients were contacted by phone and offered study participation. Participants completed a survey that assessed their awareness of HCV status, knowledge of HCV infection, and understanding of current treatment options. After survey completion, investigators provided a short 5-minute educational intervention, which covered these same concepts. Participants were offered HCV confirmatory testing. Re-engagement was measured based on the completion of the HCV RNA. <h3>Results</h3> Study investigators attempted to contact 563 patients. Of those, only 45 patients could be reached; 20 agreed to complete the survey (44% response rate). There was a delay between the generation of the potential participant list and the implementation of the intervention. The median age of participants was 47 years; 55% were male and 55% were white. Most patients (82%) had an annual income of less than $35k. Age, gender, education, and annual income were not associated with obtaining confirmatory HCV RNA testing; however, being white was associated with higher rates of confirmatory testing (<i>P</i> = 0.046). Six patients still lacked confirmatory testing at the time of study participation; all agreed to confirmatory testing, but none had completed it at 6 months after the intervention. <h3>Conclusion</h3> A telephone intervention was not successful in re-engaging patients in care for HCV. This study highlights the complexity of reaching this patient population and the need for interventions that minimize barriers in the HCV continuum of care.