Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk

Litwin, Alain H.; Smith, Bryce D.; Drainoni, Mari-Lynn; McKee, Diane; Gifford, Allen L.; Koppelman, Elisa; Christiansen, Cindy L.; Weinbaum, Cindy M.; Southern, William N.

doi:10.1016/j.dld.2011.12.014

Cited by 77 publications

(83 citation statements)

References 34 publications

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“…Successful strategies to increase HCV testing and diagnosis include interventions based on targeted case-finding (Cullen et al, 2012), risk-based assessment Litwin et al, 2012), birth-cohort screening , and motivational interviewing with case management (Masson et al, 2013). Enhanced screening could also be achieved through targeted HCV testing initiatives such as free counselling and testing, point-ofcare testing, and dried blood spot testing (Meyer, this issue).…”

Section: Epidemiology and Prevention Of Hcv Infection Among Pwidmentioning

confidence: 98%

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

Grebely

Bruggmann

Treloar

et al. 2015

International Journal of Drug Policy

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Section: Epidemiology and Prevention Of Hcv Infection Among Pwidmentioning

confidence: 98%

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

Grebely

Bruggmann

Treloar

et al. 2015

International Journal of Drug Policy

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“…The current test uptake of 51% was higher compared with international studies targeted to risk factors (10% to 49%) and other Dutch studies with a personal invitation (18% to 42%). [29][30][31][32][33][34][35][36] The family physicians' personal invitation appeared key for achieving this high uptake, as confirmed by the reported main reason to get tested. Test uptake in specific settings, such as the emergency department, may be even higher (up to 65%), 37 as here tests can be offered and performed within the routine diagnostic work-up.…”

Section: Discussionmentioning

confidence: 94%

“…A priori, we expected a test uptake of 40% based on international targeted-testing studies and Dutch studies using personal letter invitations. [29][30][31][32][33][34] A positive anti-HCV test rate higher than the estimated Dutch prevalence of 0.1%-0.4% would be considered promising to explore further assessment and implementation of the testing strategy. [23][24][25] Test uptake and rates of positive test results were calculated among the patients invited and participants, and associated determinants were assessed using multivariate logistic regression analyses; determinants included hotspot, sex, age, educational level, and hepatitis exposure risk factors as non-Western migrant, surgery abroad, blood transfusion or organ transplant before 1992, HIV positive, or a history of intravenous drug use.…”

Section: Discussionmentioning

confidence: 99%

Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing

et al. 2018

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PURPOSE Both chronic hepatitis C (HCV) and B virus (HBV) infections are generally asymptomatic, and many remain undetected or are diagnosed at a late stage. Studies that evaluate best practice hepatitis testing strategies are needed to better detect this hidden population. METHODSIn this prospective cohort study, we aimed to determine the diagnostic yield (test uptake and rate of positive test results) of a combined public health and primary care birth cohort testing strategy in detecting hidden cases of HCV and HBV infections. We invited all patients aged between 40 and 70 years (n = 6,743) registered with 11 family practices serving 2 higher prevalence areas, or hotspots (ie, estimated HCV prevalence of 1%; national estimated prevalence is 0.1-0.4%), in the south of the Netherlands. RESULTSTest uptake was 50.9% (n = 3,434 patients). No active or chronic HCV infection was detected: 0.00% (95% CI, 0.00%-0.11%). Positive test rates were 0.20% (95% CI, 0.08%-0.42%) for anti-HCV (n = 7), 0.26% (95% CI, 0.12%-0.50%) for hepatitis B surface antigen (n = 9), and 4.14% (95% CI, 3.49%-4.86%) for antihepatitis B core (n = 142).CONCLUSIONS This best practice testing strategy was effective in achieving a high test uptake. It completely failed, however, to detect hidden chronic HCV infections and is not recommended for countries with a low prevalence of the disease.

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“…Rein et al ( 13 ) While primary care settings have been shown to be a viable setting for CHC screening, it is unclear how easily this will be adopted into clinical practice. Th e most recent research eff ort from primary care clinics in the Bronx, New York demonstrated a rise from baseline 6 % screening to a modest 9.9 % for patients from the 1945 -1964 birth cohort ( 15 ). As Gastroenterologists come in contact with these patients when they are due for their screening colonoscopy, this is another potential avenue to screen this high-risk cohort.…”

Section: Guarantor Of the Articlementioning

confidence: 99%

Editorial : Killing Two Birds With One Stone: Screening for Chronic Hepatitis C at the Time of Colonoscopy in the Baby Boomer Cohort

Torres

Harrison

2013

American Journal of Gastroenterology

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Colonoscopy is a well-accepted colon cancer screening modality that is recommended by the United States Multi-Society Task Force on all individuals greater than 50 years of age. Chronic hepatitis C (CHC) is a common cause of chronic liver disease with notably increased rates of infection in individuals born between 1945 and 1965. The Centers for Disease Control recently recommended all individuals of this " Baby Boomer " cohort undergo one time screening for CHC. As gastroenterologists interface with these patients for screening colonoscopy, this represents a unique opportunity to complete this screening and identify CHC patients at risk for advanced liver disease. Am J Gastroenterol 2013; 108:990 -992; doi: 10.1038/ajg.2013 Th e United States Multi-Society Task Force fi rst included screening colonoscopy in its 1997 guidelines, which recommended colonoscopy, fl exible sigmoidoscopy, or fecal occult blood cards beginning at age 50. Colonoscopy is viewed by many as unpleasant, embarrassing, or uncomfortable, but despite this, screening rates for patients over 50 have increased considerably since 1987, rising from about 30 % to >50 % in 2005 ( 1 ). Colonoscopy is the most preferred colon cancer screening modality according to a large survey of Canadian physicians with 56 % selecting optical colonoscopy followed by 27 % preferring fecal occult blood testing ( 2 ). With the evolution of computed tomographic colonography, optical colonoscopy still remains the most widely available colon cancer screening modality ( 3 ). In the US population, the best available data reported 38.7 -40.4 % of patients older than 50 had received a fl exible sigmoidoscopy or colonoscopy in a 5-year period ( 4,5 ). Other countries have reported lower rates of colon cancer screening: a recent prospective study in Germany evaluating the effi cacy of screening colonoscopy found the cumulative participation rate to be 17 % for women and ~ 15 % for men aged 55 -74 ( 6 ).Even with the substantially lower rates of colonoscopy reported in this more recent study, it still represents a large group totaling almost 3 million individuals in Germany alone who interface with the Gastroenterology medical community. Th is is undoubtedly a prime opportunity to address other common gastrointestinal (GI) focused diseases that aff ect this population. Liver disease is not oft en a focus of many private GI practices, but as it accounts for as much morbidity and mortality as luminal GI disease, it warrants some attention. A particular liver disease that has seen great advances in treatment in the last 2 years is chronic hepatitis C (CHC) infection. CHC is one of the most common indications for liver transplant and the overall prevalence in the general population is 1 -2 % with high rates of infection in prisoners, the homeless, and US veterans ( 7 ). Th e " Baby Boomer " cohort born between 1945 and 1965 is another high-risk subgroup of patients with data suggesting >5 % prevalence of CHC ( 8 ). Th e majority of these individuals were infected before th...

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Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk

Cited by 77 publications

References 34 publications

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

Expanding access to prevention, care and treatment for hepatitis C virus infection among people who inject drugs

Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing

Editorial : Killing Two Birds With One Stone: Screening for Chronic Hepatitis C at the Time of Colonoscopy in the Baby Boomer Cohort

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