Limited provision of diagnostic services to Victorians living with hepatitis C antibodies, 2001-2012: a multi-level modelling analysis.

OBJECTIVE: To determine what percentage of Victorians with a history of notified hepatitis C exposure received appropriate follow-up diagnostic services between 2001 and 2012.

METHODS: Individual notification data and aggregate Medicare and supplementary testing data were entered into a compartmental transition model, which was used to estimate the percentage of people with a hepatitis C notification who were yet to receive either a negative diagnostic test for viral nucleic acid, or a test for viral genotype, at the end of 2012.

RESULTS: We estimate that 58.2% (uncertainty interval: 42.2%, 72.4%) of Victorians with a hepatitis C notification between 2001 and 2012 did not receive either a negative test for viral nucleic acid or a viral genotyping test during the study period. At the end of 2012, we estimate there were approximately 20,400 Victorians living with hepatitis C antibodies who were yet to receive testing, of which approximately 9,300 would have been aged 45 years or older.

CONCLUSIONS: A majority of people living with HCV antibodies in Victoria had not received appropriate secondary diagnostic services as of the end of 2012.

IMPLICATIONS: As improved therapeutic options become available for people living with chronic hepatitis C, measures to support appropriate follow-up of people with suspected or confirmed chronic infections via primary care services will be required.