Patton Fuller Financial Statements

After receiving positive antibody results, patients would then be referred onto a specialist hospital team for further assessment, to establish current or past infection and to identify the strain (genotype) of the virus. Consequently, patients were finding themselves being referred to the hospital up to three or four weeks after their initial test without being clear of their diagnosis and whether treatment should be considered. Outcomes can vary greatly according to the infecting genotype. For patients with genotype 1 infection approximately 45% clear the infection, but this rises to 80% in patients with genotypes 2 and 3. It is important that people with the virus are given this information as early as possible.

Over the past 12 months, services like ours in Sheffield have refined the screening protocol with our colleagues in the laboratory to automatically test for the virus (hepatitis C RNA) in the first sample, if antibodies are present.  This approach to testing allows the requesting clinician to inform the patient if infection is present and to advise on the course of possible treatment at a much earlier stage.

To facilitate the correct management of the patient, the laboratory has added concise comments at the end of the blood test reports. For example, if the patient is hepatitis C RNA and antibody positive: “Consistent with chronic hepatitis C infection – suggest referral to a specialist for the clinical management of hepatitis C infection”. While if the patient is hepatitis C RNA negative but antibody positive: “This patient is hepatitis C antibody positive and RNA negative.  Please send a repeat sample to confirm absence of viraemia. If confirmed, this means the patient had hepatitis C infection in the past and has now cleared and does not require further assessment.  Hepatitis C antibody does not give full protection against a future infection with hepatitis C.”  

Another successful development around diagnosis and referral for consideration of...