Missed opportunities for diagnosing viral hepatitis C in Poland. Results from routine HCV testing at the Emergency Department in the Hospital for Infectious Diseases in Warsaw

Abstract

Aim of the study: Current statistics indicate that approximately 150,000 (0.5%) people in Poland suffer from active hepatitis C virus (HCV) infection, but only 20% among them are aware of their status. This project is based on the concept that screening based on the presence of HCV-related risks (a patient's individual history and behavioural risk factors) is more effective than obligatory testing of the whole population. This study investigates prevalence of serological markers for HCV among patients with a risk of exposure to HCV infection. Material and methods: The prospective study concerning patients of 18 years and older was conducted at the Emergency Department (ED) of the Hospital for Infectious Diseases in Warsaw (from 15 September 2016 until 23 July 2018). The inclusion criteria were: a blood transfusion before 1992, more than three hospitalizations in the lifetime, suspected liver disease, elevated aminotransferase activity, imprisonment, patient's own initiative, history of injecting drug use. The rapid HCV test was performed on all patients who fulfilled inclusion criteria. The statistical analyses included calculating serological positivity rate and comparing risk-group characteristics. Results: Among 1502 patients consulted at the emergency department with risk factors for HCV infection during the study period, the HCV test was performed in 1487 cases. New diagnoses were confirmed in 25 cases, HCV seroprevalence was 1.68%, all patients were linked to care, 21/25 (84.0%) were HCV RNA positive. Conclusions: The study confirms that routine rapid testing in certain risk groups constitutes an essential tool for identifying new HCV infections and might have an important role for public health.

Hepatitis C virus infection and risk factors among patients and health-care workers of Ain Shams University hospitals, Cairo, Egypt

“…In this study, we described the HCV status and risk factors associated with anti-HCV antibodies among 500 patients admitted to the internal medicine and surgery Ain Shams hospitals in Cairo, Egypt, as well as among 50 HCWs from these two hospitals. We found a 19.80% prevalence of HCV antibodies among participating patients, which is high compared to available estimates among hospital patients from other countries that are typically below 5% [ 16 – 21 ], but in accordance with the previously observed high prevalence of HCV among Egyptian hospital patients [ 14 , 22 ]. In participating HCWs, we found a lower prevalence of 8.0%, although this is again higher than estimates from other countries [ 23 – 28 ].…”

Universal testing for hepatitis B and hepatitis C in the emergency department: a cost-effectiveness and budget impact analysis of two urban hospitals in the United Kingdom

“…Various approaches to ED testing for hepatitis have also been reported in many high income countries across Europe and North America, although many are targeted towards those at risk (drug users, or those in birth cohorts), rather than universal opt-out testing [47][48][49][50][51][52][53][54][55][56]. Most of these studies focused on HCV and HIV testing, with few testing for HBV.…”

Universal testing for hepatitis B and hepatitis C in the Emergency Department: A cost-effectiveness and budget impact analysis of two urban hospitals in the United Kingdom

“…Various approaches to ED testing for hepatitis have also been reported in many high income countries across Europe and North America, although many are targeted towards those at risk (drug users, or those in birth cohorts), rather than universal opt-out testing [47][48][49][50][51][52][53][54][55][56]. Most of these studies focused on HCV and HIV testing, with few testing for HBV.…”