Implementation of Hepatitis C Screening program for at-risk former Soviet -bloc immigrants in a large HMO

Abstract Background Hepatitis C virus (HCV) is a leading cause of liver disease worldwide. In 2021, Israel’s Ministry of Health launched a national program to screen high-risk populations, especially immigrants from former Soviet Union countries, aiming to reduce HCV-related morbidity and mortality. This study evaluates the success of Maccabi Health Services (MHS) in implementing the screening program before and after the intervention, focusing on detection, treatment, and cure rates. Methods A retrospective interrupted time-series cohort study was conducted among MHS members born in former Soviet Union countries, between 2019 and 2024. The intervention included proactive referrals for HCV antibody testing, educational messaging, and removal of bureaucratic barriers. Key outcomes: number of tests performed, positivity rates, PCR confirmation, initiation of direct-acting antiviral (DAA) treatment, and sustained virologic response (SVR). Results Of 179,658 eligible members, 82.3% were screened after the intervention (compared to only 14.2% before). The rate of positive antibody tests dropped from 2.6% pre-intervention to 1%–1.1% post-intervention. 93% of antibody-positive individuals underwent PCR confirmation, with 52% testing positive. 84% of PCR-positive patients started treatment, with higher initiation rates in the early intervention group. 69% of treated patients underwent SVR testing after treatment, with a median time of 106 days from treatment completion. Conclusions The proactive intervention by MHS led to a significant increase in screening coverage, detection, and treatment among the at-risk population. Removing barriers, providing education, and regular reminders were key to the program’s success. This structured approach can serve as a model for screening programs in other populations and countries.