Confirmation of guideline‐defined hepatitis C screening strategies within the ‘Check‐Up35+’ examination in the primary care setting

Autor: David Petroff, Ingmar Wolffram, Olaf Bätz, Katrin Jedrysiak, Jan Kramer, Thomas Berg, Johannes Wiegand
Rok vydání: 2023
Předmět:
Zdroj: Liver International. 43:785-793
ISSN: 1478-3231
1478-3223
Popis: Screening strategies for undiagnosed infections are fundamental for hepatitis C virus (HCV) elimination. We previously investigated HCV prevalence and screening strategies in an urban primary care setting. IV drug abuse, blood transfusion before 1992, immigration, or elevated ALT were identified as risk factors in a post-hoc analysis and diagnosed 83% of unknown HCV-RNA positive cases by screening only 26% of the population. We aimed to validate prospectively the proposed screening algorithm in two independent urban and rural cohorts and to analyse for potential differences.Anti-HCV and ALT were included in a routine check-up together with a questionnaire covering risk factors. HCV-RNA was analysed in anti-HCV positive individuals.In an urban and rural area, 4323 and 9321 individuals were recruited. The anti-HCV prevalence was 0.56% and 0.49%, and 0.1% of patients were HCV-RNA positive in both regions. Fifty-two anti-HCV positive patients including eight HCV-RNA positive cases were unaware of the infection (number needed to screen to detect one unknown anti-HCV positive individual: 262). At least one of the three aforementioned risk factors or elevated serum ALT were present in 3000 patients (22%). Restricting HCV screening to only those with risk factors, 52% and 75% of all anti-HCV and HCV-RNA positive undiagnosed patients were identified (number needed to screen: 111).We confirm prospectively the efficiency of a risk-based HCV screening. The risk-based algorithm should be evaluated in other countries with similarly low HCV prevalence as in Germany to achieve WHO HCV elimination goals.
Databáze: OpenAIRE
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