Hepatitis C (HCV) in HIV patients increases risk of cirrhosis and hepatocellular carcinoma (HCC).Methods
We used the BHIVA guidelines on co-infection to formulate our data fields to audit our compliance with these guidelines. We gathered information from 4 different IT systems used locally and paper notes; looking back over 5 years. Data fields include: Dates of HIV and HCV diagnoses, GP contact, transmission risk, latest CD4 count, ARV regimen, date ARV started, CD4 at ARV start, was HCV diagnosed when ARV started?, HCV treatment regimen, if acute HCV was treatment started within 6-12 months, referral to specialist, transplant, drug, alcohol and mental health services, HEV screening, HAV and HBV serology and vaccine, fibroscan, LFTs, liver biopsy, risk reduction discussion, cirrhosis on liver ultrasound, AFP, endoscopy, if no HCV treatment do they have annual fibrosis assessment?Discussion
In our HIV patients documentation of HCV care is spread over four IT systems and paper notes. The collation of data to ensure each patient is receiving appropriate care and monitoring is time-consuming and unwieldy, probably the main cause for incomplete monitoring. This audit identifies a need for a cohesive way of documentation for these patients.