305. Using Big Data to Re-Engage Hepatitis C-infected Persons: A UK Operational Delivery Network’s Experience

Abstract

BackgroundThe prevalence of hepatitis C (HCV) varies across different risk groups in the UK. In England, responsibility for the co-ordination and administration of DAAs (direct-acting antivirals) to HCV PCR positive patients is with 22 regional “Operational Delivery Networks” (ODNs). To attempt to eliminate Hepatitis C before 2030, Public Health England (PHE) and NHS England (NHSE) are attempting to re-engage previously diagnosed infected persons. To this end, ODNs have been supplied with historical antibody result data to target and reengage individuals for PCR testing and intervention if required.A study was designed to evaluate these data to help with informing ODN decisions. This study aimed to ensure that the data accurately identified patients that were PCR positive for HCV and thus fit the current criteria for receiving DAAs.MethodsThe regional ODN for the West Midlands was provided with 4540 patients with historical positive HCV antibody results, collected by a PHE surveillance system, to target for DAA intervention. DAA-treated patients had been excluded. Patient details were cross-referenced with all PCR results from January 1, 1996 up to January 1, 2019 at several regional laboratories (Public Health England Birmingham, the Queen Elizabeth Hospital, City and Sandwell Hospital) and national treatment data.ResultsPCR data were found for 988, 276 (28%) of whom had received treatment. Of the 712 persons untreated, 347 (49%) were PCR negative and thus would not fit the criteria for receiving DAAs. 365 (51%) had a positive PCR result without a record of treatment would be eligible for DAAs (see Figure 1).ConclusionOur study suggests approximately one-third of patients identified by cross-referencing NHSE treatment and PHE epidemiological HCV antibody databases will be PCR-positive and suitable for re-engagement. Epidemiological data needs to be accurately curated when implementing public health control measures. Using “Big Data” to target interventions has several limitations but can be useful. DAAs for HCV are not without risk and administration should be clinically justified. Re-testing individuals prior to intervention is essential and other methods of elimination, for example “test and treat,” may be more efficient and accurate. Disclosures All authors: No reported disclosures.