Impact of COVID-19 pandemic on diagnosis and treatment access of patients with viral hepatitis in Turkey

Fatma Eser; Rahmet Güner; Yunus Gürbüz; Meral Akdoğan; Zeynep Bilgiç; Nesibe Korkmaz; Derya Arı; Gamze Şanlıdağ; Şengül Kesim Uçar; Tolga Düzenli; Tansu Yamazhan

doi:10.3855/jidc.17585

Authors

Fatma Eser Ankara Yıldırım Beyazıt University, Ankara City Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey https://orcid.org/0000-0002-0282-6346
Rahmet Güner Ankara Yıldırım Beyazıt University, Ankara City Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey https://orcid.org/0000-0002-1029-1185
Yunus Gürbüz University of Health Sciences, Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
Meral Akdoğan University of Health Sciences, Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey
Zeynep Bilgiç Tunceli Public Hospital, Infectious Disease and Clinical Microbiology, Tunceli, Turkey https://orcid.org/0000-0001-8206-913X
Nesibe Korkmaz Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey
Derya Arı Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey
Gamze Şanlıdağ Ege University, Infectious Disease and Clinical Microbiology, İzmir, Turkey https://orcid.org/0000-0003-2275-5749
Şengül Kesim Uçar Hitit University, Infectious Disease and Clinical Microbiology, Çorum, Turkey
Tolga Düzenli Hitit University, Department of Gastroenterology, Çorum, Turkey https://orcid.org/0000-0002-6279-1018
Tansu Yamazhan Ege University, Infectious Disease and Clinical Microbiology, İzmir, Turkey

DOI:

https://doi.org/10.3855/jidc.17585

Keywords:

Hepatitis B, Hepatitis C, COVID-19, access, treatment

Abstract

Introduction: We aimed to evaluate access to diagnosis, treatment and follow-up in patients with viral hepatitis during the COVID-19 pandemic.

Methodology: Patients who started treatment for hepatitis B and hepatitis C were included in the study and analyzed in two periods: before-pandemic and during-pandemic. Indication for treatment and frequency of laboratory follow-up was obtained from hospital records. A telephone survey was administered to evaluate treatment access and compliance.

Results: Four centers with 258 patients were included in the study. Of these 161 (62.4%) were male, median age was 50 years. The number of patients, admitted to outpatient clinics was 134647 in the before-pandemic period and 106548 in the during-pandemic period. Number of patients who started treatment for hepatitis B were significantly high during-pandemic period compared with before-pandemic (78 (0.07%); 73 (0.05%) respectively; p = 0.04). The number who received treatment for hepatitis C was similar in both periods: 43 (0.04%); 64 (0.05%), respectively (p = 0.25). Prophylactic treatment for hepatitis B, due to immunosuppressive agents was significantly higher in during-pandemic period (p = 0.001). In the laboratory follow-ups at 4th, 12th and 24th weeks of treatment, worse adherence was detected in during-pandemic (for all p < 0.05). Access to treatment and compliance of all patients was over 90% and did not differ in the two periods.

Conclusions: During-pandemic, hepatitis patients' access to diagnosis, treatment initiation and follow-up had worsened in Turkey. The health policy implemented during the pandemic had a positive impact on patients' access to and compliance to treatment.