Trends in the Proportion of Hepatitis C Virus Antibody‐Positive Patients Who Could be Considered for Direct‐Acting Antiviral Therapy Identified Through Preoperative Testing for Ophthalmic Surgery: A Nationwide Multicenter Real‐World Cohort Study in Japan

Abstract

ABSTRACT Background and Aims Although the widespread use of direct‐acting antivirals (DAAs) has reduced the proportion of hepatitis C virus (HCV) antibody‐positive patients eligible for antiviral treatment, the current proportion requiring referral for DAA therapy in ophthalmology departments, which have both high testing volumes and high HCV antibody‐positive rates, remains unclear. Methods This nationwide multicenter retrospective cohort study included HCV antibody‐positive patients identified through testing in ophthalmology departments at 20 institutions in Japan between 2019 and 2023. The proportions of patients requiring referral for DAA therapy were assessed by electronic medical record (EMR) review across all 20 institutions and by a combination of EMR review and HCV antibody titer determination across nine institutions where antibody titers could be measured. Results A total of 2792 HCV antibody‐positive patients were identified across 20 institutions. Based on EMR review, the proportions requiring referral for DAA therapy were 44.4%, 38.7%, 34.2%, 38.9%, and 42.5% in 2019, 2020, 2021, 2022, and 2023, respectively. Among 1255 HCV antibody‐positive patients from 9 institutions where HCV antibody titers could be determined, the corresponding proportions assessed by combined EMR review and antibody titer determination were 28.4%, 23.7%, 20.8%, 22.4%, and 25.9%, respectively. Despite a decline in HCV antibody‐positive rates over time, the proportion requiring referral remained high. Conclusions Although the number of HCV antibody‐positive patients in ophthalmology departments has decreased, a considerable proportion could still be considered for DAA therapy. Combining HCV antibody titer determination with EMR review improves the efficiency of identifying patients requiring referral.

The authors' abstract, as published at the source. Hepatology Research, 2026 · DOI ↗