HIV and HCV screening by non-infectious diseases physicians: can we improve testing and hidden infection rates?

Autor:	García-Ruiz de Morales AG; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.; Universidad de Alcalá, Alcalá de Henares, Spain.; CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Martínez-Sanz J; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.; CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Vivancos-Gallego MJ; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.; CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Sánchez-Conde M; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.; CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Vélez-Díaz-Pallarés M; Department of Pharmacy, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain., Romero-Hernández B; Department of Microbiology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain.; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Vázquez MDG; Department of Internal Medicine, Hospital de Braga, Braga, Portugal., de Luque CMC; Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain., González-Sarria A; Department of Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain., Galán JC; Department of Microbiology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain.; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain., Rodríguez FG; Department of Gastroenterology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain., Moreno S; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.; Universidad de Alcalá, Alcalá de Henares, Spain.; CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain., Pérez-Elías MJ; Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain.; CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2023 Jun 26; Vol. 11, pp. 1136988. Date of Electronic Publication: 2023 Jun 26 (Print Publication: 2023).
DOI:	10.3389/fpubh.2023.1136988
Abstrakt:	Background: Missed opportunities for Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) testing remain high. We aimed to ascertain the knowledge of screening guidelines and attitudes of non-infectious disease (ID) hospital physicians and assess the impact of a 1-h session on screening rates and diagnoses. Methods: This interventional study consisted of a 1-h training session on HIV and HCV epidemiology and testing guidelines for non-ID physicians. Pre-and post-session questionnaires compared the knowledge of the guidelines and attitudes toward screening before and after the session. Rates of screening and diagnoses were compared in three 6 months periods: before, immediately after, and 24 months ±4 after the session. Results: A total of 345 physicians from 31 departments participated in these sessions. Before the session, 19.9% (28% medical, 8% surgical) and 17.9% (30% medical, 2.7% surgical) were aware of HIV and HCV testing guidelines, respectively. The willingness to routinely test increased from 5.6 to 22%, whereas not ordering tests decreased from 34.1 to 2.4%. HIV screening rates significantly increased by 20% after the session (7.7 vs. 9.3 tests per 103 patients; p < 0.001), and the effect persisted until the long-term period. The HIV diagnosis rate increased globally (3.6 vs. 5.2 HIV diagnoses per 105 patients; p = 0.157), mainly because of medical services (4.7 vs. 7.7 per 105 patients; p = 0.082). The HCV screening rate increased significantly immediately and in the long term only in medical services (15.7 and 13.6%, respectively). The new active HCV infection rates increased immediately and declined steeply thereafter. Conclusion: A short session for non-ID physicians can improve HIV/HCV screening, increase diagnosis, and contribute to disease elimination. Competing Interests: AG-R reports personal fees for educational events and non-financial support, including support for attending meetings and/or travel from ViiV Healthcare, Gilead Sciences, Merck Sharp & Dohme and Abbvie, outside the submitted work. JM-S reports personal fees for presentations or educational events and non-financial support, including support for attending meetings and/or travel, from ViiV Healthcare, Janssen Cilag, Gilead Sciences, Merck Sharp & Dohme and Abbvie outside the submitted work. MV-G has received honoraria (grants and personal fees) as a speaker in educational programs sponsored by ViiV, and Gilead; and has received support (registration, travel assistance) for expert courses and congresses by MSD and ViiV. BR-H has received funding to attend conferences from Gilead Sciences and obtained a financed project from Roche. SM has been involved in speaking activities and received grants for research from Gilead Sciences, Janssen Cilag, Merck, Sharp & Dohme and ViiV Healthcare. MP-E has received funding to attend conferences, educational activities or advisory, as well as scholarships from the pharmaceutical companies Gilead Sciences, Janssen, Abbvie, MSD, and ViiV. JG has received funding to attend conferences, educational activities or advisory, from the pharmaceutical companies Gilead Sciences, Abbvie, Abbott, MSD and Roche. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 García-Ruiz de Morales, Martínez-Sanz, Vivancos-Gallego, Sánchez-Conde, Vélez-Díaz-Pallarés, Romero-Hernández, Vázquez, de Luque, González-Sarria, Galán, Rodríguez, Moreno and Pérez-Elías.)
Databáze:	MEDLINE
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