RESUMEN
BACKGROUND AND AIM: undiagnosed hepatitis C virus (HCV) infection and/or inadequate access to care are barriers to the elimination of HCV. Reflex testing has proven to facilitate referral to care, treatment and viral elimination. In this study, a reflex testing program was implemented in Andalusia and its impact on access to care was evaluated. PATIENTS AND METHODS: an observational, retrospective and prospective study was performed across diagnostic laboratories responsible for HCV diagnosis in southern Spain. After surveying the barriers to performing reflex testing, the number of patients that were not referred for care in 2016 was retrospectively studied (pre-reflex cohort). Subsequently, several measures were proposed to overcome the identified barriers. Finally, reflex testing was implemented and its impact evaluated. RESULTS: the pre-reflex cohort included information from 1,053 patients. Slightly more than half of the patients (n = 580; 55%) visited a specialist for treatment evaluation during a median period of 71 days (interquartile range = 35-134) since the date of diagnosis. The post-reflex cohort (September 2017 to March 2018) included 623 patients. Only 17% (n = 106) of the patients had not been referred for care or evaluated for treatment in a median period of 52 days (interquartile range = 28-86). CONCLUSIONS: in 2016, nearly half of new HCV diagnoses in southern Spain were not referred for care. Barriers to the implementation of reflex testing were overcome in our study. Moreover, this strategy was effectively implemented in 2017. Reflex testing contributed to improving referral for care. This program will contribute to the micro-elimination of hepatitis C in Spain.
Asunto(s)
Hepacivirus , Hepatitis C , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Humanos , Estudios Prospectivos , Reflejo , Estudios Retrospectivos , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , ARN Viral/aislamiento & purificación , Cuidados Críticos , Reacción en Cadena de la Polimerasa/métodos , Betacoronavirus , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Neumonía Viral/epidemiología , Neumonía Viral/virología , España/epidemiología , Estudios Retrospectivos , Epidemiología Descriptiva , Unidades de Cuidados Intensivos , Inmunoglobulina M/sangre , Inmunoglobulina G/sangre , Cromatografía de Afinidad , Puntuaciones en la Disfunción de ÓrganosRESUMEN
BACKGROUND AND AIM: undiagnosed hepatitis C virus (HCV) infection and/or inadequate access to care are barriers to the elimination of HCV. Reflex testing has proven to facilitate referral to care, treatment and viral elimination. In this study, a reflex testing program was implemented in Andalusia and its impact on access to care was evaluated. PATIENTS AND METHODS: an observational, retrospective and prospective study was performed across diagnostic laboratories responsible for HCV diagnosis in southern Spain. After surveying the barriers to performing reflex testing, the number of patients that were not referred for care in 2016 was retrospectively studied (pre-reflex cohort). Subsequently, several measures were proposed to overcome the identified barriers. Finally, reflex testing was implemented and its impact evaluated. RESULTS: the pre-reflex cohort included information from 1,053 patients. Slightly more than half of the patients (n = 580; 55%) visited a specialist for treatment evaluation during a median period of 71 days (interquartile range = 35-134) since the date of diagnosis. The post-reflex cohort (September 2017 to March 2018) included 623 patients. Only 17% (n = 106) of the patients had not been referred for care or evaluated for treatment in a median period of 52 days (interquartile range = 28-86). CONCLUSIONS: in 2016, nearly half of new HCV diagnoses in southern Spain were not referred for care. Barriers to the implementation of reflex testing were overcome in our study. Moreover, this strategy was effectively implemented in 2017. Reflex testing contributed to improving referral for care. This program will contribute to the micro-elimination of hepatitis C in Spain
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Hepatitis C/diagnóstico , Hepatitis C/terapia , Derivación y Consulta/estadística & datos numéricos , Tamizaje Masivo , Estudios Retrospectivos , Estudios Prospectivos , EspañaRESUMEN
Mycoplasma pneumoniae has been associated with cholestatic hepatitis in children, while in adults, the lack of liver involvement has been considered as a typical feature of M. pneumoniae infection. Controversial data have been reported about the possibility of liver involvement with M. pneumoniae community-acquired pneumonia. We present two cases of acute hepatitis associated with M. pneumoniae infection without lung involvement.