Targeted hepatitis <scp>C</scp> screening among ex‐injection drug users in the community

Wong, Vincent Wai‐Sun; Wong, Grace Lai–Hung; Chim, Angel Mei‐Ling; Cheng, Tsz Yan; Cheung, Shirley Wing-Yan; Lai, Carol Man-Sze; Szeto, Kylie Joan-Yi; Tsang, Sharon; Wu, Stephen Ho-Chun; Yan, Kenneth; Hui, Alex; Yiu, Desmond C.H.; Wu, Brian Bing-Ying; Cheung, David; Chung, Cedric; Lai, Camey Wai-Man; Chan, Henry Lik‐Yuen

doi:10.1111/jgh.12355

Cited by 29 publications

(29 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…34,43 Notably, lack of insurance was not the greatest barrier to linking HCV patients to care; we were able to insure nearly all participants. Our biggest drop-off in the care continuum occurred at the subspecialty referral stage, which has not commonly been acknowledged as a barrier to care, 21,24,31 perhaps because many patients never progress to requesting referrals. Most HCV providers are subspecialists, and Health Maintenance Organizations often mandate referrals from PCPs for every visit as requirements for reimbursements.…”

Section: Discussionmentioning

confidence: 99%

“…Some, although few, studies have explored HCV screening and linkage-to-care programs in community and non-clinical settings. [20][21][22][23][24][25][26][27] Several recent efforts describe and quantify the HCV care continuum. 17,[28][29][30][31][32] Most demonstrate that chronically infected individuals fail to progress through the continuum of care and have low rates of confirmatory testing, as well as barriers to accessing health insurance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Results from a Geographically Focused, Community-Based HCV Screening, Linkage-to-Care and Patient Navigation Program

et al. 2015

View full text Add to dashboard Cite

BACKGROUND: Many of the five million Americans chronically infected with hepatitis C (HCV) are unaware of their infection and are not in care. OBJECTIVE: We implemented and evaluated HCV screening and linkage-to-care interventions in a community setting. DESIGN: We developed a comprehensive, communitybased HCV screening and linkage-to-care program in a medically underserved neighborhood with high rates of HCV infection in Philadelphia, Pennsylvania. We provided patient navigation services to enroll uninsured patients in insurance programs, facilitate referrals from primary care physicians and link patients to an HCV infectious disease specialist with intention to treat and cure. PATIENTS: Philadelphia residents were recruited through street outreach. MAIN MEASURES: We measured anti-HCV seroprevalence and diagnosis, linkage and retention in care outcomes for chronically infected patients. KEY RESULTS: We screened 1,301 participants for HCV; anti-HCV seroprevalence was 3.9 % and 2.8 % of all patients were chronically infected. Half of chronically infected patients were newly diagnosed; the remaining patients were aware of infection but not in care. We provided confirmatory RNA testing and results, assisted patients with attaining insurance and linked most chronically infected patients to a primary care provider. The biggest barrier to retaining patients in care was obtaining referrals for subspecialty providers; however, we obtained referrals for 64 % of chronically infected participants and have retained most in subspecialty HCV care. Several have commenced treatment. CONCLUSIONS: Non-clinical screening programs with patient navigator services are an effective means to diagnose, link, retain and re-engage patients in HCV care. Eliminating referral requirements for subspecialty care might further enhance retention in care for patients chronically infected with HCV.KEY WORDS: hepatitis C; HCV screening; community-based screening; patient navigation; continuum of care. J Gen Intern Med 30(7):950-7

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Results from a Geographically Focused, Community-Based HCV Screening, Linkage-to-Care and Patient Navigation Program

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In a systematic review of interventions to increase HCV testing uptake among high-risk groups such as PWID, targeted case finding, support and training for primary care practitioners, offering dried blood spot testing and the provision of outreach testing were effective (Jones et al, 2014). Enhanced screening may also be achieved through targeted HCV testing initiatives such as rapid finger-prick testing (Jewett et al, 2012;Smith et al, 2011a,b;Wong et al, 2014) and oral saliva testing (Drobnik et al, 2011;Jewett et al, 2012;Smith et al, 2011a,b). However, despite the availability of such strategies, some PWID have not received HCV testing, and evidence of effectiveness of novel approaches to increasing testing rates is needed.…”

Section: Introductionmentioning

confidence: 94%

Opioid substitution therapy is associated with increased detection of hepatitis C virus infection: A 15-year observational cohort study

Larney

Grebely²,

Falster

et al. 2015

Drug and Alcohol Dependence

View full text Add to dashboard Cite

“…The existing literature indicates a wide range of barriers for testing that are related to both the individual patient ( e.g ., lack of knowledge, not feeling sick, fear of invasive tests, and distrust of the medical system) and the healthcare provider system ( e.g ., no access to basic medical care or a lack of specific medical care in substance user treatment centers)[6-11]. …”

Section: Introductionmentioning

confidence: 99%

Dried blood spots, valid screening for viral hepatitis and human immunodeficiency virus in real-life

Mössner¹,

Staugaard²,

Jensen³

et al. 2016

WJG

View full text Add to dashboard Cite

AIMTo detect chronic hepatitis B (CHB), chronic hepatitis C (CHC) and human immunodeficiency virus (HIV) infections in dried blood spot (DBS) and compare these samples to venous blood sampling in real-life.METHODSWe included prospective patients with known viral infections from drug treatment centers, a prison and outpatient clinics and included blood donors as negative controls. Five drops of finger capillary blood were spotted on filter paper, and a venous blood sample was obtained. The samples were analyzed for HBsAg, anti-HBc, anti-HBs, anti-HCV, and anti-HIV levels as well as subjected to a combined nucleic acid test (NAT) for HBV DNA, HCV RNA and HIV RNA.RESULTSSamples from 404 subjects were screened (85 CHB, 116 CHC, 114 HIV and 99 blood donors). DBS had a sensitivity of > 96% and a specificity of > 98% for the detection of all three infections. NAT testing did not improve sensitivity, but correctly classified 95% of the anti-HCV-positive patients with chronic and past infections. Anti-HBc and anti-HBS showed low sensitivity in DBS (68% and 42%).CONCLUSIONDBS sampling, combined with an automated analysis system, is a feasible screening method to diagnose chronic viral hepatitis and HIV infections outside of the health care system.

show abstract

Targeted hepatitis C screening among ex‐injection drug users in the community

Abstract: Targeted screening in ex-IDUs is effective in identifying patients with HCV infection in the community. Improvement in the referral system and introduction of interferon-free regimens are needed to increase treatment uptake.

Cited by 29 publications

References 30 publications

Results from a Geographically Focused, Community-Based HCV Screening, Linkage-to-Care and Patient Navigation Program

Results from a Geographically Focused, Community-Based HCV Screening, Linkage-to-Care and Patient Navigation Program

Opioid substitution therapy is associated with increased detection of hepatitis C virus infection: A 15-year observational cohort study

Dried blood spots, valid screening for viral hepatitis and human immunodeficiency virus in real-life

Contact Info

Product

Resources

About