Emergency department targeted screening for hepatitis C does not improve linkage to care  

作　　者：Inbal Houri Noya Horowitz Helena Katchman Yael Weksler Ofer Miller Liat Deutsch Oren Shibolet 

机构地区：[1]Department of Gastroenterology and Hepatology,Tel-Aviv Medical Center,Tel-Aviv 6423906,Israel [2]Sackler Faculty of Medicine,Tel-Aviv University,Tel-Aviv 6997801,Israel

出　　处：《World Journal of Gastroenterology》2020年第32期4878-4888,共11页世界胃肠病学杂志（英文版）

基　　金：Supported by an Educational Grant from AbbVie Inc.Israel.

摘　　要：BACKGROUND Hepatitis C virus(HCV)infection is a leading cause of chronic liver disease worldwide.New treatments for HCV revolutionized management and prompted the world health organization to set the goal of viral elimination by 2030.These developments strengthen the need for HCV screening in order to identify asymptomatic carriers prior to development of chronic liver disease and its complications.Different screening strategies have been attempted,most targeting high-risk populations.Previous studies focusing on patients arriving at emergency departments showed a higher prevalence of HCV compared to the general population.AIM To identify previously undiagnosed HCV carriers among high risk emergency room attendees and link them to care for anti-viral treatment.METHODS In this single center prospective study,persons visiting the emergency department in an urban hospital were screened by a risk factor-specific questionnaire.The risk factors screened for were exposure to blood products or organ transplantation before 1992;origins from countries with high prevalence of HCV;intravenous drug use;human immunodeficiency virus carriers;men who have sex with men;those born to HCV-infected mothers;prior prison time;and chronic kidney disease.Those with at least one risk factor were tested for HCV by serum for HCV antibodies,a novel oral test from saliva(OraQuick®)or both.RESULTS Five hundred and forty-one participants had at least one risk factor and were tested for HCV.Eighty four percent of all study participants had only one risk factor.Eighty five percent of participants underwent OraQuick®testing,34%were tested for serum anti-HCV antibodies,and 25%had both tests.3.1%of patients(17/541)had a positive result,compared to local population incidence of 1.96%.Of these,82%were people who inject drugs(current or former),and 64%served time in prison.One patient had a negative HCV-RNA,and two patients died from non-HCV related reasons.On review of past medical records,12 patients were found to have been previously diagnosed wi

关 键 词：SCREENING Emergency departments Israel SALIVA Hepatitis C Liver 

分 类 号：R473.5[医药卫生—护理学]