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Barro Lugo S, Flamarich Gol C, González Martínez MÁ, Sampedro Elvira Á, Saperas Pérez C, Sánchez Collado C. [Chronic communicable and non-communicable pathology and skin pathology of the migrant patient]. Aten Primaria 2024; 56:102922. [PMID: 38583414 PMCID: PMC11002854 DOI: 10.1016/j.aprim.2024.102922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 04/09/2024] Open
Abstract
The care of migrant patients includes initial screening and lifelong monitoring, highlighting the importance of preventing and tracking chronic, communicable and non-communicable diseases. The prevalence of hypertension, diabetes mellitus, dyslipidemia, and obesity varies by ethnicity, influenced by genetic factors, lifestyle, and socio-economic status. Preventive measures, health promotion, and risk factor identification are crucial. Chronic communicable diseases may manifest years after transmission, underscoring the necessity of primary care screening, especially for populations from endemic or high-risk areas. Imported skin lesions are a common reason for consultation among migrant and traveller patients. Their ethiology is varied, ranging from common conditions such as scabies, mycoses, and urticaria to tropical dermatoses like filariasis and leprosy.
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Affiliation(s)
- Silvia Barro Lugo
- Centro de Atención Primaria Larrard, Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria.
| | - Clara Flamarich Gol
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Equipo de Atención Primaria Sant Roc, Institut Català de la Salut, IDIAP Jordi Gol Gorina, Badalona, Barcelona, España
| | - M Ángeles González Martínez
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Trinitat Vella, Institut Català de la Salut, Sant Andreu, Barcelona, España
| | - Ángela Sampedro Elvira
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Gornal, L'Hospitalet de Llobregat, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España
| | - Carme Saperas Pérez
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Plana Lledó, Mollet del Vallès, Institut Català de la Salut, Metropolitana Nord, Mollet del Vallès, Barcelona, España
| | - Consuelo Sánchez Collado
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Garrotxa-Olot Nord, Institut Català de la Salut, Girona, Olot, Girona, España
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Conthe A, Ahumada A, Gallego Durán R, Marti-Aguado D, Ibáñez-Samaniego L. Current dilemmas in hepatitis virus C management. What should we do after achieving sustained virologic response? GASTROENTEROLOGIA Y HEPATOLOGIA 2023; 46:826-829. [PMID: 37813183 DOI: 10.1016/j.gastrohep.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Andrés Conthe
- Sección de Hepatología, Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBERehd), Spain.
| | - Adriana Ahumada
- Sección de Hepatología, Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rocío Gallego Durán
- Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBERehd), Spain; SeLiver Group, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - David Marti-Aguado
- Servicio de Aparato Digestivo, Hospital Clínico Universitario de Valencia, INCLIVA Instituto de Investigación Sanitaria, Valencia, Spain
| | - Luis Ibáñez-Samaniego
- Sección de Hepatología, Servicio de Aparato Digestivo, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBERehd), Spain
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Crespo J, Cabezas J, Aguilera A, Berenguer M, Buti M, Forns X, García F, García-Samaniego J, Hernández-Guerra M, Jorquera F, Lazarus JV, Lens S, Martró E, Pineda JA, Prieto M, Rodríguez-Frías F, Rodríguez M, Serra MÁ, Turnes J, Domínguez-Hernández R, Casado MÁ, Calleja JL. Recommendations for the integral diagnosis of chronic viral hepatitis in a single analytical extraction. GASTROENTEROLOGIA Y HEPATOLOGIA 2023; 46:150-162. [PMID: 36257502 DOI: 10.1016/j.gastrohep.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/08/2022] [Accepted: 09/28/2022] [Indexed: 11/11/2022]
Abstract
The Spanish Society of Digestive Pathology (SEPD), the Spanish Association for the Study of the Liver (AEEH), the Spanish Society of Infections and Clinical Microbiology (SEIMC) and its Viral Hepatitis Study Group (GEHEP), and with the endorsement of the Alliance for the Elimination of Viral Hepatitis in Spain (AEHVE), have agreed on a document to carry out a comprehensive diagnosis of viral hepatitis (B, C and D), from a single blood sample; that is, a comprehensive diagnosis, in the hospital and/or at the point of care of the patient. We propose an algorithm, so that the positive result in a viral hepatitis serology (B, C and D), as well as human immunodeficiency virus (HIV), would trigger the analysis of the rest of the virus, including the viral load when necessary, in the same blood draw. In addition, we make two additional recommendations. First, the need to rule out a previous hepatitis A virus (VHA) infection, to proceed with its vaccination in cases where IgG-type studies against this virus are negative and the vaccine is indicated. Second, the determination of the HIV serology. Finally, in case of a positive result for any of the viruses analyzed, there must be an automated alerts and initiate epidemiological monitoring.
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Affiliation(s)
- Javier Crespo
- Servicio de Gastroenterología y Hepatología, Grupo de Investigación Clínica y Traslacional en Enfermedades Digestivas, Instituto de Investigación Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, España.
| | - Joaquín Cabezas
- Servicio de Gastroenterología y Hepatología, Grupo de Investigación Clínica y Traslacional en Enfermedades Digestivas, Instituto de Investigación Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, España
| | - Antonio Aguilera
- Servicio de Microbiología, Hospital Clínico Universitario de Santiago de Compostela, Departamento de Microbioloxía y Parasitoloxía, Universidade de Santiago de Compostela, A Coruña, España
| | - Marina Berenguer
- Unidad de Hepatología y Trasplante Hepático y CIBEREHD, Hospital Universitario y Politécnico La Fe; IIS La Fe y Universidad de Valencia, Valencia, España
| | - María Buti
- Servicio de Hepatología, Hospital Universitario Valle Hebrón y CIBEREHD del Instituto Carlos III, Barcelona, España
| | - Xavier Forns
- Servicio de Hepatología, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBEREHD, Barcelona, España
| | - Federico García
- Servicio de Microbiología, Hospital Universitario Clínico San Cecilio, Instituto de Investigación IBS, Ciber de Enfermedades Infecciosas (CIBERINFEC), Granada, España
| | | | - Manuel Hernández-Guerra
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, España
| | - Francisco Jorquera
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED y CIBEREHD, León, España
| | - Jeffrey V Lazarus
- Instituto de Salud Global de Barcelona (ISGlobal), Hospital Clínic, Universidad de Barcelona, Barcelona, España
| | - Sabela Lens
- Servicio de Hepatología, Hospital Clínic de Barcelona, IDIBAPS, CIBEREHD, Universidad de Barcelona, Barcelona, España
| | - Elisa Martró
- Servicio de Microbiología, Laboratori Clínic Metropolitana Nord (LCMN), Hospital Universitario Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol (IGTP), Badalona (Barcelona), España, Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España
| | - Juan Antonio Pineda
- Departamento de Medicina, Universidad de Sevilla, Hospital Universitario de Valme, Ciber de Enfermedades Infecciosas (CIBERINFEC), Sevilla, España
| | - Martín Prieto
- Unidad de Hepatología y Trasplante Hepático, Hospital Universitario y Politécnico La Fe, Valencia, CIBEREHD, Instituto de Salud Carlos III, Madrid, España
| | - Francisco Rodríguez-Frías
- Servicios de Microbiología y Bioquímica, Laboratorios Clínicos Hospital Universitario Vall d'Hebron, CIBEREHD, Instituto de investigación Vall d'Hebron (VHIR), Barcelona, España
| | - Manuel Rodríguez
- Sección de Hepatología, Servicio de Digestivo, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Universidad de Oviedo, Oviedo, España
| | - Miguel Ángel Serra
- Catedrático Jubilado de Medicina, Universidad de Valencia, Valencia, España
| | - Juan Turnes
- Servicio de Digestivo, Hospital Universitario de Pontevedra, Pontevedra, España
| | | | | | - José Luis Calleja
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro, Instituto de Investigación Puerta de Hierro Majadahonda (IDIPHIM), Universidad Autónoma de Madrid, Madrid, España
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Vallejo A, Moldes LM, Trigo M, Ordoñez P, Rodriguez-Otero L, Cabrera JJ, Gude MJ, Navarro D, Cañizares A, García-Campello M, Agulla A, Aguilera A. Generalized implementation of reflex testing of hepatitis C in Galicia: Results for reflection. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:483-488. [PMID: 35729051 DOI: 10.1016/j.eimce.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/11/2020] [Accepted: 12/18/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The implementation of reflex testing of active hepatitis C virus (HCV) infection, together with the incorporation of informative alerts in the reports, has shown that it significantly reduces the number of patients who were not referred for therapeutic evaluation. METHODS Since the implementation in 2018 of the DUSP in the Microbiology Services of the Galician Health Service hospitals (SERGAS), new diagnoses of active HCV infection have been retrospectively identified and characterized. RESULTS In 2018, a total of 258 patients with unknown active HCV infection (70,2% men, middle age 52 years) were identified through by reflex testing from consultations of primary and specialized care units in 54.8% and 39.8% respectively, as well as from other locations by 5.4%. Of the 258 patients, 81.0% were referred for therapeutic evaluation, with a median of 54 days from their diagnosis. In 58.3% of the cases the reflex testing was determined by viral load, the predominant genotype was 1a (30,7%) and 52,1% were treated, observing sustained viral response (SVR) in 93.7 % of these. CONCLUSION The generalized implementation of the HCV reflex testing together with informative alerts in Galicia has allowed us to obtain referral rates for treatment similar to those obtained in other studies. However, there is a wide variability between the different centers that require the incorporation of improvements, such as training or the use of rescue measures for optimization.
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Affiliation(s)
- Aldara Vallejo
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela (La Coruña), Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Luz María Moldes
- Servicio de Microbiología, Complexo Hospitalario Universitario de A Coruña, La Coruña, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Matilde Trigo
- Servicio de Microbiología, Complexo Hospitalario de Pontevedra, Pontevedra, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Patricia Ordoñez
- Servicio de Microbiología, Complexo Hospitalario Arquitecto Marcide-Profesor Novoa Santos, Ferrol (La Coruña), Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Luis Rodriguez-Otero
- Servicio de Microbiología, Complexo Hospitalario Universitario de Ourense, Ourense, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Jorge Julio Cabrera
- Servicio de Microbiología, Hospital Universitario Álvaro Cunqueiro, Vigo (Pontevedra), Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - María José Gude
- Servicio de Microbiología, Hospital Universitario Lucus Augusti, Lugo, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Daniel Navarro
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela (La Coruña), Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Angelina Cañizares
- Servicio de Microbiología, Complexo Hospitalario Universitario de A Coruña, La Coruña, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Marta García-Campello
- Servicio de Microbiología, Complexo Hospitalario de Pontevedra, Pontevedra, Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Andrés Agulla
- Servicio de Microbiología, Complexo Hospitalario Arquitecto Marcide-Profesor Novoa Santos, Ferrol (La Coruña), Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain
| | - Antonio Aguilera
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela (La Coruña), Spain; Departamento de Microbioloxia e Parasitoloxía, Universidade de Santiago de Compostela, Santiago de Compostela (La Coruña), Spain; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), Spain.
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Patient journey of individuals tested for HCV in Spain: LiverTAI, a retrospective analysis of EHRs through natural language processing. GASTROENTEROLOGÍA Y HEPATOLOGÍA 2022:S0210-5705(22)00253-9. [DOI: 10.1016/j.gastrohep.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/14/2022] [Accepted: 10/16/2022] [Indexed: 11/27/2022]
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Hepatitis B and C screening in hospitalized patients with SARS-CoV-2 infection. GASTROENTEROLOGÍA Y HEPATOLOGÍA (ENGLISH EDITION) 2022. [PMCID: PMC9040534 DOI: 10.1016/j.gastre.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Aims To evaluate the results of a hepatitis B and C screening program in hospitalized COVID-19 patients. Method Transversal prospective study conducted in two Spanish hospitals. Patients admitted from March 1st to December 31st 2020 with a diagnosis of COVID-19 were tested for markers of hepatitis B (HBsAg, anti-HBc) and C (anti-HCV, HCV RNA) infection. Results In this period, 4662 patients with COVID-19 were admitted to our centers: 56.3% were male, median age was 76 (0–104) years. Data regarding HBV infection was available in 2915 (62.5%) patients; 253 (8.75%) were anti-HBc + and 11 (0.38%) HBsAg+. From these, 4 patients did not have a previous diagnosis of hepatitis B, 7 received corticosteroids and one received prophylaxis. There was one HBV reactivation. Anti-HCV were available in 2895 (62%) patients; 24 (0.83%) were positive. From these, 13 patients had a previous hepatitis C diagnosis: 10 patients had been treated with SVR, one achieved spontaneous cure and 2 did not receive treatment. From the 11 previously unknown anti-VHC + patients, 10 had a negative HCV RNA. Overall, only 3 (0.10%) patients tested RNA HCV + . However, none received HCV treatment (2 older than 90 years with comorbidities, 1 died from COVID-19). Conclusion Screening of hepatitis C infection in hospitalized COVID-19 patients seems less useful than expected. The low prevalence of active infection after antiviral treatments and the high age of our population limit the detection of potential candidates for treatment. HBV screening should be aimed to prevent reactivation under immunosuppressive treatments.
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Forns X, Colom J, García‐Retortillo M, Quer JC, Lens S, Martró E, Domínguez‐Hernández R, Casado MÁ, Buti M. Point-of-care hepatitis C testing and treatment strategy for people attending harm reduction and addiction centres for hepatitis C elimination. J Viral Hepat 2022; 29:227-230. [PMID: 34806812 PMCID: PMC9299793 DOI: 10.1111/jvh.13634] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/05/2021] [Accepted: 11/02/2021] [Indexed: 12/09/2022]
Abstract
According to WHO goals, the elimination of Hepatitis C Virus (HCV) by 2030 requires enhancing and simplifying HCV testing. Our aim was to create a model to assess and compare different strategies for HCV testing, linkage to care and treatment among people who access harm reduction centres (HRC) and Addiction Centres in Catalonia. A decision tree model was designed to evaluate two strategies: Hepatitis C Point-of-care (POC) "test and treat", at the community versus standard-of-care (SOC), in which HCV testing was performed at community and therapy at the hospital. Both strategies were assessed separately in HRCs (6,878 users) and Addiction Centres (13,778 users). with a time horizon of 18 months. Healthcare outcomes were HCV testing, linkage to care, treatment outcomes and reinfection rate. HCV testing was performed in 3,178 (46%) of the HRC users. Compared with SOC, POC increased access to treatment by 57% (63% vs. 6%). SVR rates were 64% in POC vs. 23% in SOC. Reinfection rates were 21% with POC compared to 24% with SOC. With POC, losses to follow-up were reduced by 41%. In the Addiction Centres, 12,566 users (91%) were screened using the two strategies. Compared to the SOC, POC increased access to treatment and linkage to care by 19% along with SVR at the same rate. Reinfection rates decreased by 6%. Thus, the implementation of a POC "test and treat" strategy at HRCs and Addiction Centres has shown to be an effective public health strategy to help eliminating HCV in accordance with WHO goal.
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Affiliation(s)
- Xavier Forns
- Liver UnitHospital Clínic de BarcelonaIDIBAPSUniversity of BarcelonaBarcelonaSpain,CIBERehdInstituto Carlos IIIBarcelonaSpain
| | - Joan Colom
- Programme for Prevention, Control and Treatment of HIV, STIs and Viral HepatitisProgramme on Substance AbuseAgency of Public Health of CataloniaBarcelonaSpain
| | | | - Joan Carles Quer
- Gastroenterology DepartmentUniversity Hospital Joan XXIIITarragonaSpain
| | - Sabela Lens
- Liver UnitHospital Clínic de BarcelonaIDIBAPSUniversity of BarcelonaBarcelonaSpain,CIBERehdInstituto Carlos IIIBarcelonaSpain
| | - Elisa Martró
- Microbiology DepartmentLaboratori Clínic Metropolitana Nord. Hospital Universitari Germans Trias i Pujol. Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP)BadalonaSpain,Biomedical Research Networking Centre in Epidemiology and Public Health (CIBERESP)Instituto de Salud Carlos III. MadridSpain
| | | | | | - María Buti
- CIBERehdInstituto Carlos IIIBarcelonaSpain,Liver UnitInternal Medicine DepartmentHospital Universitari Vall d'HebronBarcelonaSpain
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Lazarus JV, Villota-Rivas M, Fernández I, Gea F, Ryan P, López SA, Guy D, Calleja JL, García-Samaniego J. A cascade of care analysis on the elimination of hepatitis C from public hospitals in Madrid. COMMUNICATIONS MEDICINE 2022; 2:20. [PMID: 35603271 PMCID: PMC9053180 DOI: 10.1038/s43856-022-00077-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022] Open
Abstract
Background Direct-acting antivirals can cure ≥95% of hepatitis C virus (HCV) cases, but do not reach everyone in need. This cross-sectional study analyses the HCV cascade of care (CoC) in Madrid, Spain, in high-risk patients, to inform micro-elimination measures. Methods From September 2019 to May 2021, data from medical records were collected and analysed from six public hospitals in Madrid, including seven adult, high-risk patient groups: patients in haemodialysis or pre-dialysis programmes, co-infected with HIV, with advanced liver disease (ALD), with hereditary haematological diseases, with transplants and people who inject drugs (PWID). Results Here we present an analysis of 3994 patients (68.8% male), 91.2% were tested for anti-HCV and 28.9% were positive. Of the total, 34.5% were tested for HCV–RNA and 62.4% of these were positive. Of those HCV–RNA positive, 98.0% were treatment-eligible: in 7.4%, treatment is ongoing and in 89.3% completed. Of the latter, 92.2% obtained a sustained virological response 12 weeks post treatment (SVR12). Of those with ongoing or completed treatment, 9.8% experienced loss to follow-up (LTFU) or had unknown SVR12, 50.3% developed hepatic and 20.3% extrahepatic complications. ALD patients had the highest proportion of HCV–RNA positives (32.5%). The lowest proportion of patients treated were PWID (85.2%). Conclusions Almost one in ten high-risk patients in six of Madrid’s public hospitals remains untested for HCV antibodies. An almost equal percentage of those untested have experienced LTFU, with the highest proportion in PWID. This approach to monitoring the HCV CoC is vital to inform measures to eliminate HCV in hospitals. Despite the existence of effective treatments with few side effects for hepatitis C virus (HCV), such treatments do not reach everyone in need and this means we cannot eliminate HCV. Here, we analysed HCV diagnoses, patients’ access to care and treatment rates in high-risk populations in major public hospitals in Madrid. Data were collected from adult patients in haemodialysis or pre-dialysis programmes, co-infected with HIV, with advanced liver disease, with hereditary haematological diseases, with transplants and people who inject drugs (PWID). Nearly 10% of high-risk patients in six of Madrid’s public hospitals did not have an initial test for HCV. An almost equal percentage of those who were not tested for HCV have not continued to be followed for care, primarily PWID. This approach to monitoring the HCV cascade of care is vital to inform measures to eliminate HCV in hospitals. Lazarus et al. evaluate the cascade of care for people with hepatitis C virus (HCV) treated within six public hospitals in Madrid, Spain. The authors report on potential gaps in care in specific populations, including inadequate testing and loss to follow-up, and their implications on HCV micro-elimination in Madrid.
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Aguilera A, Eiros JM, García F. Impact of COVID-19 pandemic on hepatitis C elimination from the clinical microbiologist perspective. Are we ready? ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2021; 39:475-476. [PMID: 34454863 PMCID: PMC8387201 DOI: 10.1016/j.eimce.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/20/2020] [Indexed: 06/13/2023]
Affiliation(s)
- Antonio Aguilera
- Complejo Hospitalario Universitario de Santiago de Compostela, Departamento de Microbiología, Universidad de Santiago de Compostela e Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | | | - Federico García
- Hospital Clínico Universitario San Cecilio, Instituto de Investigación Biosanitaria Ibs.Granada, Granada, Spain.
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Gómez Camarero J, Badia Aranda E, Quiñones Castro R, Saiz Chumillas RM, Alcoba Vega L, Díez Ruiz S, Gómez Manero N, Vinuesa Campo R, Jorquera Plaza F. Hepatitis B and C screening in hospitalized patients with SARS-CoV-2 infection. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 45:256-264. [PMID: 34508809 PMCID: PMC8426135 DOI: 10.1016/j.gastrohep.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/20/2021] [Accepted: 09/01/2021] [Indexed: 12/03/2022]
Abstract
Objetivo Evaluar el resultado del cribado de hepatitis B y C en pacientes ingresados con COVID-19. Pacientes y métodos Estudio transversal, prospectivo, realizado en dos hospitales españoles de tercer nivel. Se estudiaron marcadores de hepatitis B (HBsAg, anti-HBc) y C (anti-VHC, ARN VHC) a todos los pacientes hospitalizados con COVID-19 del 1 de marzo al 31 de diciembre de 2020. Resultados En este periodo ingresaron 4662 pacientes con COVID-19: 56,3% fueron varones, la edad mediana fue 76 (0-104) años. Se realizó serología de hepatitis B a 2915 (62,5%) pacientes; 253 (8,75%) presentaban anti-HBc + y 11 (0,38%) HBsAg + . De los 11 pacientes, 4 desconocían el diagnóstico, 7 recibieron esteroides y uno recibió profilaxis. Hubo un caso de reactivación del VHB. Se determinaron anticuerpos anti-VHC a 2895 (62%) pacientes; 24 (0,83%) fueron positivos. De ellos, 13 pacientes estaban diagnosticados: 10 habían recibido tratamiento, uno se había curado espontáneamente y dos no habían sido tratados. De los 11 restantes, 10 tenían ARN VHC indetectable. En total, solo 3 (0,10%) pacientes tenían carga viral detectable. Sin embargo, ninguno recibió tratamiento (2 > 90 años con comorbilidades, uno falleció por COVID-19). Conclusiones El cribado de hepatitis C en pacientes ingresados por COVID-19 en nuestro medio ha mostrado menor utilidad de la esperada. La baja prevalencia de infección activa tras los tratamientos antivirales y la alta edad mediana de nuestra población limitan la detección de potenciales candidatos a tratamiento. El cribado de hepatitis B debería dirigirse a prevenir la reactivación en pacientes que precisen tratamientos inmunosupresores.
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Affiliation(s)
| | - Ester Badia Aranda
- Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Burgos, España
| | - Raisa Quiñones Castro
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, León, España
| | | | - Laura Alcoba Vega
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, León, España
| | - Sandra Díez Ruiz
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, León, España
| | - Noemí Gómez Manero
- Servicio de Medicina Interna, Hospital Universitario de Burgos, Burgos, España
| | | | - Francisco Jorquera Plaza
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, León, España; Instituto Universitario de Biomedicina (IBIOMED), Universidad de León, León, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España
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12
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Burgui C, Martín C, Aguinaga A, Pérez-García A, Ezpeleta C, Castilla J. Prevalence and detection of undiagnosed active hepatitis C virus infections in Navarre, Spain, 2017-2019. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 113:28-34. [PMID: 33207891 DOI: 10.17235/reed.2020.7000/2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND undiagnosed active hepatitis C virus (HCV) infection remains an obstacle towards its eradication. This study aimed to estimate the prevalence of HCV infection and to describe the diagnostic advances in Navarre, Spain. METHODS HCV-infection diagnostic performance was analyzed in Navarre's primary and specialized health care between 2017 and 2019. The prevalence of undiagnosed infections was estimated for patients with programmed surgeries unrelated to HCV infection, who underwent a routine HCV antibody (anti-HCV) determination. HCV-RNA (viral load) was quantified in anti-HCV positive cases. The prevalence was standardized according to the sex and age distribution in the general population. RESULTS from the 63,405 subjects examined for anti-HCV, 84 (five per 100,000 person-years) were diagnosed with an active infection. In Primary Health Care, 20,363 patients were analyzed and 47 active infections were detected, i.e. one case for every 433 people tested, implying 56 % of all identified active infections. On the other hand, 9,399 surgical patients were analyzed and 120 anti-HCV positive cases were detected (adjusted prevalence: 1.47 %; 95 % CI: 1.24-1.52). A positive viral load had been determined at any time in 66 cases (0.61 %), of which five were undiagnosed active infections (adjusted prevalence: 0.04 %; 95 % CI: 0.01-0.11). Preoperative screening allowed the detection of one undiagnosed infection per 795 people analyzed aged between 45 and 64 years. CONCLUSIONS Primary Health Care efficiently contributes to the detection of undiagnosed HCV active infections. This may be speeded up by performing population screening, targeting subjects between 45 and 64 years of age.
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Affiliation(s)
- Cristina Burgui
- Epidemiología, Instituto de Salud Pública de Navarra, España
| | - Carmen Martín
- Microbiología Clínica, Complejo Hospitalario de Navarra
| | | | | | | | - Jesús Castilla
- Epidemiología, Instituto de Salud Pública y Laboral de Navarra, España
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Reygosa C, Morales-Arraez D, Hernández-Bustabad A, Melián Baute L, Hernández-Guerra M. Hepatitis C-treated patients as a potential source for referral of new cases. GASTROENTEROLOGIA Y HEPATOLOGIA 2021; 44:704-710. [PMID: 34023471 DOI: 10.1016/j.gastrohep.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/20/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Direct-acting antivirals (DAAs) are an opportunity for hepatitis C virus (HCV) elimination. Strategies are needed to diagnose new patients and to attract those diagnosed without evaluation. Patients with other chronic viral diseases who receive satisfactory treatment promote referral of other patients for evaluation. Our aim was to evaluate whether patients who have been treated with DAAs would recommend follow-up and treatment to other patients as well as the characteristics that influence this decision. PATIENTS AND METHODS Two-hundred and 2HCV-infected patients treated with DAAs were included. Patients were asked about whether they knew other infected people and their willingness to share their experience. A general satisfaction survey and a specific HCV satisfaction survey were carried out. Demographic, socioeconomic and HCV infection variables were recorded. RESULTS Despite the fact that 54.4% of the patients reported knowing others infected, 34.2% would not fully agree to share their experience. The analysis of general and specific satisfaction showed that patients who shared their experience mentioned a perception of greater care from the specialist (4.7±0.4 vs. 4.3±0.6, P=.001) and had more information on treatment expectations (4.6±0.5 vs. 4.0±0.7, P=.001) and social support (4.5±0.7 vs. 4.0±0.8, P=.001). CONCLUSIONS The perception by treated patients of general satisfaction with the healthcare process and information about benefits influences the degree of recommendation to other infected people. Knowledge about treatment and perception of improvement in health of treated patients should be enhanced as it can contribute to increasing referrals to specialized consultation.
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Affiliation(s)
- Cristina Reygosa
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Dalia Morales-Arraez
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Alberto Hernández-Bustabad
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Lorelay Melián Baute
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España
| | - Manuel Hernández-Guerra
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, España; Instituto Universitario de Tecnologías Biomédicas CIBICAN, Departamento de Medicina Interna, Psiquiatría y Dermatología, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, España.
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14
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Vallejo A, Moldes LM, Trigo M, Ordoñez P, Rodriguez-Otero L, Cabrera JJ, Gude MJ, Navarro D, Cañizares A, García-Campello M, Agulla A, Aguilera A. Generalized implementation of reflex testing of hepatitis C in Galicia: Results for reflection. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00025-2. [PMID: 33632540 DOI: 10.1016/j.eimc.2020.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/11/2020] [Accepted: 12/18/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The implementation of reflex testing of active hepatitis C virus (HCV) infection, together with the incorporation of informative alerts in the reports, has shown that it significantly reduces the number of patients who were not referred for therapeutic evaluation. METHODS Since the implementation in 2018 of the DUSP in the microbiology services of the Galician Health Service hospitals (SERGAS), new diagnoses of active HCV infection have been retrospectively identified and characterized. RESULTS In 2018, a total of 258 patients with unknown active HCV infection (70,2% men, middle age 52 years) were identified through by reflex testing from consultations of primary and specialized care units in 54.8% and 39.8% respectively, as well as from other locations by 5.4%. Of the 258 patients, 81.0% were referred for therapeutic evaluation, with a median of 54 days from their diagnosis. In 58.3% of the cases the reflex testing was determined by viral load, the predominant genotype was 1a (30,7%) and 52,1% were treated, observing sustained viral response in 93.7% of these. CONCLUSION The generalized implementation of the HCV reflex testing together with informative alerts in Galicia has allowed us to obtain referral rates for treatment similar to those obtained in other studies. However, there is a wide variability between the different centers that require the incorporation of improvements, such as training or the use of rescue measures for optimization.
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Affiliation(s)
- Aldara Vallejo
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela (La Coruña), España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Luz María Moldes
- Servicio de Microbiología, Complexo Hospitalario Universitario de A Coruña, La Coruña, España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Matilde Trigo
- Servicio de Microbiología, Complexo Hospitalario de Pontevedra, Pontevedra, España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Patricia Ordoñez
- Servicio de Microbiología, Complexo Hospitalario Arquitecto Marcide-Profesor Novoa Santos, Ferrol (La Coruña), España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Luis Rodriguez-Otero
- Servicio de Microbiología, Complexo Hospitalario Universitario de Ourense, Orense, España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Jorge Julio Cabrera
- Servicio de Microbiología, Hospital Universitario Álvaro Cunqueiro, Vigo (Pontevedra), España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - María José Gude
- Servicio de Microbiología, Hospital Universitario Lucus Augusti, Lugo, España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Daniel Navarro
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela (La Coruña), España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Angelina Cañizares
- Servicio de Microbiología, Complexo Hospitalario Universitario de A Coruña, La Coruña, España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Marta García-Campello
- Servicio de Microbiología, Complexo Hospitalario de Pontevedra, Pontevedra, España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Andrés Agulla
- Servicio de Microbiología, Complexo Hospitalario Arquitecto Marcide-Profesor Novoa Santos, Ferrol (La Coruña), España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España
| | - Antonio Aguilera
- Servicio de Microbiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela (La Coruña), España; Departamento de Microbioloxia e Parasitoloxía, Universidade de Santiago de Compostela, Santiago de Compostela (La Coruña), España; Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela (La Coruña), España.
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Cabezas J, García F, Calleja Panero JL, Buti M, Molero García JM, Blasco AJ, Lázaro de Mercado P, Crespo J. Principles for implementing a population screening strategy for hepatitis C in Spain. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 112:64-70. [PMID: 31880160 DOI: 10.17235/reed.2019.6768/2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND hepatitis C, besides health impairment, results in significant loss of productivity and diminished quality of life, and noticeably contributes to health expenditure increases. Because of all this, the Spanish Ministry of Health (Ministerio de Sanidad, Consumo y Bienestar Social - MSCBS) implemented in 2015 a strategic plan for managing hepatitis C (Plan Estratégico para el Abordaje de la Hepatitis C - PEAHC) within the National Health System. However, the PEAHC includes no screening plan. The MSCBS developed a framework document on population screening (Documento Marco sobre Cribado Poblacional) that defines the criteria a disease must meet in order to consider implementing a screening program. Specifically, it defines 4 criteria related to the health issue, 4 related to the screening test, and 3 criteria dealing with diagnosis confirmation and treatment. OBJECTIVE to identify whether there is scientific evidence to support hepatitis C meeting the criteria to be considered a disease qualifying for a population screening strategy in Spain. METHODS a literature search for scientific evidence concerning each required criterion for implementing a population screening plan for hepatitis C in Spain. RESULTS sufficient scientific evidence was found to support hepatitis C meeting the criteria required by the MSCBS for the implementation of a population screening program. CONCLUSIONS according to the available scientific evidence, hepatitis C in Spain meets the required criteria to qualify for consideration of population screening plan.
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Affiliation(s)
- Joaquín Cabezas
- Aparato Digestivo/Unidad de Hepatología, Hospital Universitario Marqués de Valdecilla, España
| | - Federico García
- Servicio de Microbiología, Hospital Universitario San Cecilio. Instituto de Investigación Ibs
| | - José Luis Calleja Panero
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro Majadahonda
| | - María Buti
- Servicio de Aparato Digestivo, Hospital Universitari Vall d´Hebron
| | | | | | | | - Javier Crespo
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, 39002
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Gutiérrez García ML, Gómez Perosanz R, Acedo Sanz JM, Delgado-Iribarren García-Campero A, Claudio Domínguez I, Domenech Gómez-Imaz A, Pérez Encinas M, de la Fuente Hermosín I, Fabero Jimenez A, Fernández Rodríguez CM. Coordinated assistance plan for the elimination of hepatitis C virus at the centro de ayuda integral al drogodependiente (CAID (Comprehensive Care Centre for Drug Addicts)). GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 44:214-220. [PMID: 33162188 DOI: 10.1016/j.gastrohep.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The drug-injecting population has a high prevalence of hepatitis C virus (HCV) and high risk of transmission. It is a priority to establish an agile diagnostic and treatment plan. OBJECTIVES 1) Assess the effectiveness of a new coordinated care plan of referral from the Comprehensive Care Centre for Drug Addicts (CAID) to specialised care and 2) Determine the prevalence of HCV, clinical characteristics, effectiveness and safety of treatment in this population. METHODS 1,300 serologies requested by the CAID between 1998 and 2018 were retrospectively analysed, the seroprevalence of HCV was calculated and the efficiency of the traditional CAID-specialised care referral system was evaluated. A care plan was designed and coordinated among specialists involved in diagnosis and treatment. Since October 2018, 11 patients have been included in the new plan and the performance of both referral systems was compared. RESULTS With the traditional system, 48.2% (83/172) of the patients were lost. 14.5% (172/1,300) presented positive HCV serology, compared to the general population OR = 19; 95% CI 14.3-25. The prevalence of active infection was 80.3% (90/112). The prevalence of active infection was 80.3% (90/112). Of the 11 patients referred by the new plan, 76.9% (8/11) had active infection and 100% (8/8) were treated with Direct Antiviral Agents successfully. CONCLUSIONS The new coordinated CAID-specialised care plan presents high effectiveness in comparison with the traditional referral system. The seroprevalence and prevalence of active infection in the CAID population is very high. Treatments with Direct Antiviral Agents are effective and safe.
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Affiliation(s)
| | - Raquel Gómez Perosanz
- Servicio de Aparato Digestivo, Hospital Universitario Fundación Alcorcón, Madrid, España
| | | | | | | | | | | | | | - Aurora Fabero Jimenez
- Dirección de Continuidad Asistencial, Hospital Universitario Fundación Alcorcón, Madrid, España
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Saludes V, Antuori A, Lazarus JV, Folch C, González-Gómez S, González N, Ibáñez N, Colom J, Matas L, Casabona J, Martró E. Evaluation of the Xpert HCV VL Fingerstick point-of-care assay and dried blood spot HCV-RNA testing as simplified diagnostic strategies among people who inject drugs in Catalonia, Spain. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 80:102734. [PMID: 32470849 DOI: 10.1016/j.drugpo.2020.102734] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/14/2020] [Accepted: 03/17/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Catalonia requires decentralized and simplified strategies for the diagnosis of viremic HCV infection among people who inject drugs (PWID). We aimed to perform a direct comparison of the diagnostic performance between two, single-step strategies for the screening and diagnosis of viremic HCV infection in PWID attending a drug consumption room (DCR) in Barcelona: i) on-site HCV-RNA testing using the point-of-care test (PoCT) Xpert HCV VL Fingerstick; and ii) on-site dried blood spots (DBS) collection for HCV-RNA testing at the laboratory (in-house assay). Additionally, we aimed to assess participants' preferences in receiving HCV-RNA testing results and feasibility of same-day delivery of PoCT results. METHODS The real-world, clinical performance of these two strategies was established in comparison with the reference method (HCV viral load testing with the Xpert HCV Viral Load assay at the laboratory from venous plasma collected at the DCR). HCV genotypes/subtypes and HIV status were also determined by sequencing and serology, respectively. A questionnaire including preferences regarding the delivery of test results was administered. RESULTS The prevalence of HCV-RNA was 63.0% (of which 25.8% were co-infected with HIV). The RNA-PoCT showed a sensitivity of 98.4% for detectable viral loads (>4 IU/mL) and of 100% for quantifiable viral loads (≥10, ≥1000 and ≥3000 IU/mL). For the DBS-based assay, a sensitivity of 93.7% was obtained for detectable viral loads, 96.7% for the quantifiable ≥10 IU/mL threshold, and 98.3% for both the quantifiable ≥1000 and ≥3000 IU/mL thresholds. No significant differences were detected between the sensitivity values of these two strategies, and the specificity was 100% in both cases. Half of the participants preferred to receive the HCV-RNA result on the same day, and 80% of participants received their RNA-PoCT results on the same day. CONCLUSIONS Both the HCV-RNA PoCT and the DBS-based assay are highly reliable tools for the simplified diagnosis of viremic HCV infection among current PWID. These strategies allow for on-site sample collection and delivery of test results, facilitating decentralized care in harm reduction services.
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Affiliation(s)
- V Saludes
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - A Antuori
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - J V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - C Folch
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Public Health Agency of Catalonia (ASPCAT), Badalona, Spain
| | - S González-Gómez
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - N González
- Drug consumption room "El Local", IPSS Foundation, Sant Adrià del Besòs, Barcelona, Spain
| | - N Ibáñez
- Program on Substance Abuse, ASPCAT, Barcelona, Spain
| | - J Colom
- Program for the Prevention, Control and Treatment of HIV, Sexually Transmitted Infections and Viral Hepatitis, ASPCAT, Barcelona, Spain
| | - L Matas
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - J Casabona
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Public Health Agency of Catalonia (ASPCAT), Badalona, Spain
| | - E Martró
- Microbiology Department, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
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Hepatitis C reflex testing in Spain in 2019: A story of success. Enferm Infecc Microbiol Clin 2020; 39:119-126. [PMID: 32451150 DOI: 10.1016/j.eimc.2020.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/12/2020] [Accepted: 03/22/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Reflex testing is necessary to achieve the objectives of hepatitis C elimination. However, in 2017 only 31% of Spanish hospitals performed reflex test. As a consequence of that finding, reflex testing was recommended by scientific societies involved in the diagnosis and treatment of hepatitis C. OBJECTIVE To evaluate the degree of implementation of reflex testing in 2019 and to know the implementation of rapid diagnostic and/or dried blood spot testing (RDT and / or DBS) in Spanish hospitals. METHODS Cross-sectional study through a survey conducted in October 2019 to Spanish general hospitals with at least 200 beds, public or private with teaching accreditation. RESULTS 129 (80%) hospitals responded. Reflex testing is performed by 89% of the centers vs. 31% in 2017 (P<.001). From 2017 to 2019, centers using alerts to improve continuity of care increased from 69% to 86% (P=.002). In 2019, 11% of centers can determine anti-HCV in dried spot, 15% viremia in dried spot, 0.85% anti-HCV in saliva, and 37% of antibodies and/or viremia with point of care test. 43% of hospitals have at least one diagnostic method with RDT and/or DBS. CONCLUSION The implementation of reflex testing has increased significantly, reaching 89% of hospitals in 2019. The recommendations of scientific societies could have contributed to the implementation of reflex testing. On the other hand, access to RDT and/or DBS is insufficient and initiatives are needed to improve their implementation.
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