Hepatitis C (HCV) is a curable disease, yet many patients remain untreated due to lack of awareness, outdated perceptions, and barriers to care. This project aimed to identify and link untreated HCV RNA-positive individuals to care within a large, not-for-profit health system in Virginia. A retrospective chart review identified 4,367 adults with no documented HCV treatment between 2016 and 2024. After thorough chart review, external lab verification, and use of public records, 3,221 (73.8%) were excluded due to prior treatment, age, relocation, death, or incarceration.

Of the remaining 1,147 patients, 503 (43.9%) had unreachable or invalid contact information, and 336 (29.3%) did not respond to messages. Ultimately, 111 individuals (9.7%) were successfully linked to care, and 43 (3.8%) declined. Patient feedback revealed both skepticism and gratitude. Some viewed the outreach as a scam, while others were deeply moved, expressing appreciation that someone “remembered” them. Many were unaware treatment was available or believed they were not sick enough to qualify.
This project underscores the challenges of delayed HCV care, the limitations of EHR documentation, and the need for dedicated, person-centered outreach. Future directions include using artificial intelligence to enhance identification and documentation of HCV status, and encouraging more timely, trusted referrals through known providers. Despite obstacles, this proactive approach demonstrated that personal outreach can successfully re-engage patients and reduce the long-term burden of untreated HCV.