Potential Screening Strategies for Patients with Hepatitis C with Indications for Direct-Acting Antiviral Treatment

Background: This study aimed to determine the number of patients with positive HCV RNA results who were eligible to receive direct-acting antiviral (DAA) therapy at Nara Medical University and to identify effective screening methods in this population. Methods: Between June 2021 and May 2024, the RNA detection status of HCV antibody-positive cases, including RNA detection rates (RNA detection number/antibody positive number) and positive rates (RNA positive number/RNA detection number), were evaluated. Results: Among the 866 patients who underwent anti-HCV testing, HCV RNA was assessed in 29.2% (n = 253, including department of Gastroenterology; n = 57, other departments n = 196). Among the 253 (29.2%) patients, 26 (45.6％) and 16 (8.2%), patients from the Gastroenterology and other departments, respectively, tested positive for HCV-RNA. The remaining 70.8% (n = 613) (41 cases in the department of Gastroenterology and 572 cases in the others). Based onthe RNA positivity rate of the facilities, 613 (70.8%) tested for HCV antibody, will include 66 potential RNA patients included 19 patients (45.6％) in Gastroenterology and 47 patients (8.2％) in the other departments. Conclusions: Overall, 66 patients will potentially remain HCV RNA positive. Simultaneous evaluation of HCV antibodies and HCV RNA can efficiently identify patients with chronic HCV infection who are eligible for DAA therapy.