Hepatitis B screening in an argentine ED: Increasing vaccination in a resource-limited setting

Ford, James S.; Marianelli, L; Frassone, Natalia; Debes, José D.

doi:10.1016/j.ajem.2019.158354

Cited by 8 publications

(9 citation statements)

References 14 publications

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“…The simple collection process (finger-prick or mouth swab) is also highly acceptable, feasible and attractive to people undergoing testing [ 22 , 24 , 25 ]. A key benefit of POCs in the field of hepatitis B is to engage hard-to-reach communities for testing, such as using HBsAg POC tests for hepatitis B screening in remote areas, or harm reduction programs [ 24 , 25 , 26 , 27 ]. POCs also have great potential for retaining patients in care when used in the community for chronic hepatitis B stage evaluation and disease monitoring [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

“…A key benefit of POCs in the field of hepatitis B is to engage hard-to-reach communities for testing, such as using HBsAg POC tests for hepatitis B screening in remote areas, or harm reduction programs [ 24 , 25 , 26 , 27 ]. POCs also have great potential for retaining patients in care when used in the community for chronic hepatitis B stage evaluation and disease monitoring [ 26 , 27 ]. Figure 2 outlines the key phases of disease in chronic hepatitis B infection and the indicators for blood testing in each stage.…”

Section: Introductionmentioning

confidence: 99%

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Point-of-Care Tests for Hepatitis B: An Overview

Xiao

Thompson

Howell

2020

Cells

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Despite the heavy disease burden posed by hepatitis B, around 90% of people living with hepatitis B are not diagnosed globally. Many of the affected populations still have limited or no access to essential blood tests for hepatitis B. Compared to conventional blood tests which heavily rely on centralised laboratory facilities, point-of-care testing for hepatitis B has the potential to broaden testing access in low-resource settings and to engage hard-to-reach populations. Few hepatitis B point-of-care tests have been ratified for clinical use by international and regional regulatory bodies, and countries have been slow to adopt point-of-care testing into hepatitis B programs. This review presents currently available point-of-care tests for hepatitis B and their roles in the care cascade, reviewing evidence for testing performance, utility, acceptability, costs and cost-effectiveness when integrated into hepatitis B diagnosis and monitoring programs. We further discuss challenges and future directions in aspects of technology, implementation, and regulation when adopting point-of-care testing in hepatitis B programs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Point-of-Care Tests for Hepatitis B: An Overview

Xiao

Thompson

Howell

2020

Cells

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“…5 The emergency department (ED) is often used by underserved, high-risk populations, making it an important setting to deliver healthcare services to patients who are not seen in traditional outpatient settings. 6,7 ED-based screening programs have demonstrated success in screening for other infectious diseases such as human immunodeficiency virus (HIV) and hepatitis B virus. 6,8 However, due to difficulties with patient follow-up and linkage to care, using the ED as a setting for delivery of public health interventions remains controversial.…”

Section: How Does This Improve Population Health?mentioning

confidence: 99%

“… 6 , 7 ED-based screening programs have demonstrated success in screening for other infectious diseases such as human immunodeficiency virus (HIV) and hepatitis B virus. 6 , 8 However, due to difficulties with patient follow-up and linkage to care, using the ED as a setting for delivery of public health interventions remains controversial. Previous studies have investigated the role of the ED in screening for HCV, in both targeted and nontargeted populations.…”

Section: Introductionmentioning

confidence: 99%

Universal Screening for Hepatitis C Virus in the ED Using a Best Practice Advisory

Ford¹,

Chechi²,

Toosi³

et al. 2021

WJEM

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Introduction In 2019 the United States Preventive Services Task Force (USPSTF) released draft guidelines recommending universal hepatitis C virus (HCV) screening for individuals aged 18–79. We aimed to assess the efficacy of an emergency department-based HCV screening program, by comparing screening practices before and after its implementation. Methods We performed a retrospective cohort analysis of two temporally matched, 11-month study periods, corresponding to before and after the implementation of a best practice advisory (BPA). Patients were screened for anti-HCV antibody (Ab), and positive results were followed by HCV viral load (VL) testing. The primary implementation outcome was ED testing volume (number of tests performed/month). The primary screening outcomes were the seroprevalence of anti-HCV Ab and HCV VL. We describe data with simple descriptive statistics. Results The median age of patients was similar between periods (pre: 50 years [interquartile range [IQR] 34–62], post: 47 years [IQR 33–59]). Patients screened were more likely to be males in the pre-BPA period (Male, pre: 60%, post: 49%). During the pre-BPA study period, a total of 69,604 patients were seen in the ED, and 218 unique patients were screened for HCV (mean 19.8 tests/month). During the post-BPA study period, a total of 68,225 patients were seen in the ED, and 14,981 unique patients were screened for HCV (mean 1361.9 tests/month). Anti-HCV Ab seroprevalence was 23% (51/218) and 9% (1340/14,981) in the pre-BPA and post-BPA periods, respectively. In the pre-BPA period, six patients with a positive anti-HCV Ab level had follow-up VL testing (detectable in three). In the post-BPA period, reflex VL testing was performed in most patients (91%, 1225/1,340), and there were 563 patients with detectable VLs, indicating active infection. Conclusion Our study shows that using a universal BPA-driven screening protocol can dramatically increase the number of patients screened for HCV and increase the number of new HCV diagnoses.

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“…The Emergency Department (ED) is an important safety net for underserved, high‐risk populations, making it a vital setting to deliver healthcare services to patients without access to primary care 7,8 . Compelling evidence continues to emerge on the utility of ED‐based infectious diseases screening programs, including those for Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) 8–13 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for hepatitis C virus infection at a large urban emergency department

Ford

Hollywood

Steuble

et al. 2022

Journal of Viral Hepatitis

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There are an estimated 184 million people that have been infected with hepatitis C virus (HCV) in the world. 1 In the United States (U.S.), HCV is the most common and deadliest blood-borne infection in the country, and the number of new acute HCV infections almost tripled between 2011 and 2019 (17,100 to 50,300). 2,3 As many as 85% of individuals with acute HCV will become chronically infected, predisposing them to the life-threatening consequences of cirrhosis and hepatocellular carcinoma. 3 The World Health Organization (WHO) has targeted an 80% global reduction in new chronic HCV infections by 2030. 4 To meet this goal, population-level HCV screening initiatives are needed. In 2019, the U.S. Preventative Service Task Force (USPSTF) released guidelines recommending HCV screening in all adults aged 18-79 years, and in 2020,

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Hepatitis B screening in an argentine ED: Increasing vaccination in a resource-limited setting

Cited by 8 publications

References 14 publications

Point-of-Care Tests for Hepatitis B: An Overview

Point-of-Care Tests for Hepatitis B: An Overview

Universal Screening for Hepatitis C Virus in the ED Using a Best Practice Advisory

Risk factors for hepatitis C virus infection at a large urban emergency department

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