Emergency department testing is feasible but ineffective to eliminate hepatitis C in Denmark.
Infect Dis (Lond)
; 53(12): 930-941, 2021.
Article
em En
| MEDLINE
| ID: mdl-34379569
ABSTRACT
BACKGROUND:
As direct-acting antiviral treatment for hepatitis C virus (HCV) is widely available in Denmark, the hindrance to achieving elimination lies in identifying infections. Effective identification relies on screening in high-risk populations. Here, we report the outcomes of a risk-based, point-of-care (POC) screening strategy in a Danish emergency department (ED).METHODS:
During a three-month period, ED patients at Odense University Hospital were screened for risk factors and offered POC HCV-antibody (HCV-Ab) testing. Reactive results were followed up by confirmatory venepuncture testing. The main outcome measure was prevalence of HCV-antibodies. Secondary outcome measures were prevalence of risk factors and an evaluation of feasibility of ED screening.RESULTS:
During study times, 1831 (55.7%) of 3288 presentations to the ED were eligible for screening. Six hundred and seventy-three (36.8%) were approached, of which 514 (28.1%) participated and 159 (8.7%) declined. Of 514 participants, 339 (66%) reported one or more risk factors, and 489 (95.1%) underwent HCV-Ab testing. Four (0.8%) had a reactive HCV-Ab test. No active infections of HCV were found. The risk factor of having injected drugs was present in all HCV-Ab positive patients. Compared to participants, patients who could not be approached had a lower prevalence of previously diagnosed hepatitis C- and risk-factor-associated diagnoses.CONCLUSIONS:
The risk factor of injecting drug use had the highest yield for HCV-Ab positivity. Additional risk factors did not contribute to case-finding. This screening strategy was feasible but ineffective. Further testing strategies will be necessary to identify the remaining hepatitis C patients in Denmark.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Hepatite C
/
Hepatite C Crônica
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Infect Dis (Lond)
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Dinamarca