Barriers in the HCV care cascade and medical knowledge in Argentina

Abstract

Introduction: In Argentina, the prevalence of hepatitis C virus (HCV) infection is close to 0.5%. Only half of those affected are aware of their diagnosis, and less than 5% accessed treatment in 2020.

Objective: To identify barriers in the care cascade and assess medical knowledge about HCV diagnosis and treatment.

Methods: Anonymous survey distributed electronically between February and March 2025, targeting different physicians specialties. A total of 124 responses were analyzed using descriptive statistics.

Results: Fifty-six percent of respondents were infectious disease specialists, 18% were clinicians, 11% were pediatricians, 8% were hepatologists, and 7% were general practitioners. Forty percent of respondents had more than 20 years of experience in the profession, and 27% had less than 10 years. Ninety percent were from Buenos Aires City and the province of Buenos Aires, and 70% worked in the public health system. The main setting was inpatient care 49 (46%) and outpatient care 43  (40%). The main barriers identified were diagnosis (53%), treatment (45%), and post-treatment follow-up (37%). Regarding diagnosis, 97% have serology and only 31% have serology, viral load, and genotype; with the possibility of referral in 100% of cases. Only 15% use reflex testing; the delay between diagnosis and treatment initiation was 2–6 months in 49% of cases. With respect to the treatment, less than half (36.2%) are aware of the treatments available in their workplace and their indications, and in 60% of cases, treatment is provided by hepatology and infectious disease specialists. Twenty-five percent do not feel qualified to prescribe treatment, and 30% are una}ware of direct-acting antiviral regimens.

Conclusions: Currently, multiple barriers persist in the HCV care cascade in our country, and the situation is exacerbated by a lack of medical knowledge. There is an urgent need to move toward decentralization of diagnosis and treatment. Increasing the use of reflex testing, strengthening ongoing training for healthcare teams, and promoting intersectoral collaboration are essential to ensure sustained and equitable access to treatment.