Stages of care for patients with chronic hepatitis C at a hospital in southern Brazil

Table 1 Analysis of variables with absolute number and relative percentage (%) and Poisson regression with robust simple variance of each variable in relation to steps of cascade of care of patients diagnosed with hepatitis C virus infection at the Hospital Nossa Senhora da Conceição between 2015 and 2020

	Total (%)	PCR-HCV collection	P value	Specialized assistance	P value	Treatment	P value	SVR	P value
Total	709	534 (75.3%)		461 (65.0%)		344 (48.5%)		204 (28.7%)
Gender
Female	324 (45.7%)	238 (73.5%); 0.95 (0.87-1.04)	0.295	221 (68.2%); 1.09 (0.98-1.21)	0.101	175 (54.0%); 1.23 (1.05-1.43)	0.007	109 (62.3%); 1.10 (0.92-1.32)	0.253
Male	385 (54.3%)	296 (76.9%); 1.0		240 (62.3%); 1.0		169 (43.9%); 1.0		95 (56.2%); 1.0
Age (yr)
17-39	118 (16.6%)	90 (76.3%); 1.0		79 (66.9%); 1.0	0.420	52 (44.1%); 1.0		27 (51.9%); 1.0
40-59	348 (49.1%)	267 (76.7%); 1.00 (0.89-1.13)	0.920	225 (64.7%); 0.96 (0.83-1.12)	0.646	170 (48.9%); 1.10 (0.88-1.39)	0.380	103 (60.6%); 1.16 (0.87-1.55)	0.294
> 60	243 (34.3%)	177 (72.8%); 0.95 (0.84-1.08)	0.479	157 (64.6%); 0.96 (0.82-1.12)	0.657	122 (50.2%); 1.13 (0.89-1.44)	0.284	74 (60.7%); 1.16 (0.86-1.57)	0.307
Race
White	543 (76.6%)	405 (74.6%); 1.0		353 (65.0%); 1.0		269 (49.5%); 1.0		164 (61.0%); 1.0
Non-white	154 (21.7%)	118 (76.6 %); 1.02 (0.92-1.13)	0.598	97 (63.0%); 0.96 (0.84-1.11)	0.649	65 (42.2%); 0.85 (0.69-1.04)	0.123	32 (49.2%); 0.80 (0.62-1.05)	0.113
Education
Illiterate	39 (5.5%)	28 (71.8%); 0.88 (0.71-1.08)	0.238	26 (66.7%); 0.95 (0.74-1.22)	0.741	20 (51.3%); 0.96 (0.68-1.35)	0.834	13 (65.0%); 0.95 (0.66-1.36)	0.804
Elementary school	478 (67.4%)	344 (72%); 0.88 (0.80-0.97)	0.011	301 (63.0%); 0.90 (0.79-1.03)	0.134	219 (45.8%); 0.86 (0.71-1.03)	0.110	120 (54.8%); 0.80 (0.66-0.98)	0.031
High school and university	141 (19.9%)	115 (81.6%); 1.0		98 (69.5%); 1.0		75 (53.2%); 1.0		51 (68.0%); 1.0
City of origin
Porto Alegre	317 (44.7%)	215 (67.8%); 1.0		174 (54.9%); 1.0		121 (38.2%); 1.0		49 (40.5%); 1.0
Metropolitan region	247 (34.8%)	190 (76.9%); 1.13 (1.02-1.25)	0.016	166 (67.2%); 1.22 (1.07-1.39)	0.003	126 (51.0%); 1.33 (1.11-1.60)	0.002	81 (64.3%); 1.58 (1.23-2.04)	0
Countryside	134 (18.9%)	118 (88.1%); 1.29 (1.17-1.43)	0	112 (83.6%); 1.52 (1.34-1.72)	0	91 (67.9%); 1.77 (1.48-2.13)	0	68 (74.7%); 1.84 (1.44-2.36)	0
Follow-up site
HNSC	341 (48.1%)	320 (93.8%); 1.61 (1.47-1.76)	0	340 (99.7%); 3.03 (2.62-3.50)	0	237 (69.5%); 2.39 (2.00-2.84)	0	166 (70.0%); 1.97 (1.50-2.58)	0
External	121 (17.1%)	214 (58.2%); 1.0		121 (32.9%); 1.0		107 (29.1%); 1.0		38 (35.5%); 1.0
Institutionalized
Yes	33 (4.7%)	25 (75.8%); 1.0		18 (54.5%); 1.0		12 (36.4%); 0.74 (0.46-1.17)	0.198	8 (66.7%); 1.12 (0.74-1.70)
No	676 (95.3%)	509 (75.3%); 1.00 (0.82-1.22)	0.952	443 (65.5%); 0.83 (0.60-1.14)	0.255	332 (49.1%); 1.0		196 (59.0%); 1.0	0.561
Co-infection with HBV
Yes	73 (10.3%)	61 (83.6%); 1.12 (1.00-1.25)	0.041	43 (58.9%); 1.0		30 (41.1%); 0.83 (0.62-1.10)	0.208	18 (60.0%); 1.01 (0.74-1.37)	0.935
No	636 (89.7%)	473 (74.4%); 1.0		418 (65.7%); 0.89 (0.73-1.09)	0.282	314 (49.4%); 1.0		186 (59.2%); 1.0	0.935
Co-infection with HIV
Yes	93 (13.1%)	75 (80.6%); 1.08 (0.97-1.20)	0.158	63 (67.7%); 1.04 (0.90-1.22)	0.541	35 (37.6%); 0.75 (0.57-0.98)	0.039	17 (48.6%); 0.80 (0.56-1.14)	0.222
No	616 (86.9%)	459 (74.5%); 1.08		398 (64.6%); 1.0		309 (50.2%); 1.0		187 (60.5%); 1.0
Cirrhosis
Yes	126 (17.8%)	112 (88.9%); 1.22 (1.13-1.33)	0	106 (84.1%); 1.38 (1.25-1.52)	0	82 (65.1%); 1.44 (1.23-1.69)	0	60 (73.2%); 1.33 (1.12-1.57)	0.001
No	583 (82.2%)	422 (72.4%); 1.0		355 (60.9%); 1.0		262 (44.9%); 1.0		144 (55.0%); 1.0
Date of diagnosis
2015	149 (21.0%)	111 (74.5%); 1.0		102 (68.5%); 1.0		76 (51%); 1.0		42 (55.3%); 1.0
2016	136 (19.2%)	113 (83.1%); 1.11 (0.98-1.25)	0.076	101 (74.3%); 1.08 (0.93-1.25)	0.278	72 (52.9%); 1.03 (0.83-1.29)	0.744	51 (70.8%); 1.28 (0.99-1.64)	0.052
2017	121 (17.1%)	92 (76.0%); 1.02 (0.89-1.17)	0.771	84 (69.4%); 1.01 (0.86-1.19)	0.865	68 (56.2%); 1.10 (0.88-1.37)	0.393	45 (66.2%); 1.19 (0.91-1.56)	0.181
2018	121 (17.1%)	80 (66.1%); 0.88 (0.75-1.04)	0.140	72 (59.5%); 0.86 (0.72-1.04)	0.133	53 (43.8%); 0.85 (0.66-1.10)	0.244	30 (56.6%); 1.04 (0.75-1.39)	0.880
2019	128 (18.1%)	90 (70.3%); 0.94 (0.81-1.09)	0.440	67 (52.3%); 0.76 (0.62-0.93)	0.008	49 (38.3%); 0.75 (0.57-0.98)	0.038	22 (44.9%); 0.81 (0.56-1.17)	0.272
2020	54 (7.6%)	48 (88.9%); 1.19 (1.04-1.36)	0.009	35 (64.8%); 0.94 (0.75-1.18)	0.634	26 (48.1%); 0.94 (0.68-1.29)	0.723	14 (53.8%); 0.97 (0.64-1.46)	0.901

P value < 0.20 was considered significant. HNSC: Hospital Nossa Senhora da Conceição; HCV: Hepatitis C virus; HBV: Hepatitis B virus; SVR: Sustained virologic response.

Table 2 Poisson regression analysis with multivariable robust variance of significant variables in relation to steps of cascade of care of patients diagnosed with hepatitis C virus infection at the Hospital Nossa Senhora da Conceição between 2015 and 2020

	PCR-HCV collection	P value	Specialized assistance	P value	Treatment	P value	SVR	P value
Gender
Female			0.06 (0.97-1.16)	0.148	1.20 (1.03-1.40)	0.014
Male			1.00		1.00
Race
White					1.0		1.0
Non-white					0.99 (0.81-1.21)	0.931	0.95 (0.72-1.25)	0.734
Education
Illiterate	0.83 (0.67-1.03)	0.103	0.87 (0.73-1.04)	0.152	0.76 (0.53-1.09)	0.145	0.63 (0.35-1.12)	0.120
Elementary school	0.89 (0.81-0.97)	0.014	0.94 (0.85-1.04)	0.244	0.85 (0.72-1.02)	0.082	0.79 (0.65-0.95)	0.014
High school and university	1.0		1.0		1.0		1.0
City of origin
Porto Alegre	1.0		1.0		1.0		1.0
Metropolitan region	1.11 (1.00-1.23)	0.033	1.12 (1.00-1.24)	0.034	1.19 (0.98-1.45)	0.074	1.54 (1.19-1.98)	0.001
Countryside	1.19 (1.08-1.33)	0.001	1.14 (1.03-1.25)	0.009	1.38 (1.14-1.68)	0.001	1.62 (0.24-2.12)	0.000
Follow-up site
HNSC	1.58 (1.43-1.75)	0.000	3.00 (2.58-3.50)	0.000	2.19 (1.80-2.65)	0.000	1.59 (1.20-2.09)	0.001
External	1.0		1.0		1.0		1.0
Institutionalized
Yes					0.70 (0.42-1.17)	0.178
No					1.0
Co-infection with HBV
Yes	1.11 (0.97-1.27)	0.121
No	1.0
Co-infection with HIV
Yes	1.11 (0.97-1.27)	0.121			0.80 (0.59-1.08)	0.156
No	1.0				1.0
Cirrhosis
Yes	1.02 (0.94-1.11)	0.504	0.96 (0.90-1.03)	0.327	1.07 (0.91-1.62)	0.363	1.18 (0.91-1.36)	0.275
No	1.0		1.0		1.0		1.0
Date of diagnosis
2015	1.0		1.0		1.0		1.0	1.000
2016	1.02 (0.90-1.16)	0.662	0.90 (0.80-1.01)	0.083	0.82 (0.65-1.03)	0.102	1.05 (0.80-1.37)	0.701
2017	0.97 (0.84-1.12)	0.711	0.93 (0.81-1.06)	0.311	0.96 (0.76-1.20)	0.730	1.06 (0.80-1.41)	0.652
2018	0.90 (0.77-1.05)	0.213	0.92 (0.79-1.07)	0.321	0.83 (0.64-1.07)	0.153	0.93 (0.67-1.30)	0.685
2019	1.02 (0.88-1.19)	0.717	0.88 (0.76-1.03)	0.118	0.81 (0.62-1.05)	0.125	0.81 (0.57-1.16)	0.267
2020	1.27 (1.09-1.48)	0.002	1.03 (0.86-1.25)	0.698	1.02 (0.75-1.39)	0.879	0.96 (0.66-1.40)	0.862

P value < 0.05 was considered significant. HCV: Hepatitis C virus; SVR: Sustained virologic response; HNSC: Hospital Nossa Senhora da Conceição.

Table 3 Comparison between patients with hepatitis C virus infection who underwent follow-up at the Hospital Nossa Senhora da Conceição and external ones using Pearson’s chi-square test

	HNSC	External	P value
Total	340 (73.8%)	121 (26.2%)
Gender			0.654
Female	161 (47.2%)	60 (49.6%)
Age (yr)			0.854
< 40	60 (17.6%)	19 (15.7%)
40-59	167 (49.0%)	59 (48.8%)
> 60	114 (33.4%)	43 (35.5%)
Race			0.450
White	262 (79.2%)	91 (75.8%)
Education			0.411
Illiterate	22 (7.1%)	4 (3.5%)
Elementary school	218 (69.9%)	83 (73.5%)
High school and university	72 (23.1%)	26 (23.0%)
City of origin			0.006
Porto Alegre	121 (36.4%)	53 (43.8%)
Metropolitan region	116 (34.9%)	51 (42.1%)
Countryside	95 (28.6%)	17 (14.0%)
Cirrhosis			0.000
Yes	100 (29.3%)	7 (5.8%)

P value < 0.05 was considered significant. HNSC: Hospital Nossa Senhora da Conceição.