Hepatitis C screening in hospitals: find the missing patients
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RESEARCH
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Hepatitis C screening in hospitals: find the missing patients Lili Liu1, Hongqin Xu1, Yue Hu2, Jia Shang3, Jianning Jiang4, Lei Yu5, Caiyan Zhao6, Dazhi Zhang7, Xinxin Zhang8, Junfeng Li9, Wei Li3, Yanan Wu3, Diefei Hu4, Xiaofang Wang10, Qian Zhao6, Qiongfang Zhang7, Wenqiang Luo7, Jia Chen8, Donghua Zhang8, Wei Zhou9 and Junqi Niu1*
Abstract Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver cancer, creating enormous economic and social burdens. The Chinese government recommends routine screening of inpatients for HCV before invasive procedures to prevent iatric infections. However, the diagnosis and treatment rates for HCV remain low. The aim of this study was to use available routine screening data to understand the HCV screening of inpatients in different regions of China. Methods: Inpatient information and HCV screening results were collected from January 2016 to December 2016 at eight tertiary hospitals in different regions of China to compare the HCV-positivity of hospitalized patients among different regions and age groups. Results: The HCV screening rate of inpatients was more than 50%. A total of 467,008 inpatients were enrolled in the study (51.20% were male), and the HCV antibody (anti-HCV) -positive rate was 0.88% (95% confidence interval [CI], 0.85–0.91%) among the total population. This rate was significantly higher among all males compared with all females (0.91% vs 0.85%). Moreover, the HCV antibody-positive rate increased with age and was highest for the 60– 64-year age group. Notably, 90.14% (3722/4129) of the anti-HCV seropositive patients were 40 years of age or older. HCV screening for people over 40 years old is recommended. Conclusions: This study highlights the key role of routine examination for HCV infection in hospitalized patients. Full use of inpatient screening results to manage HCV antibody-positive patients and a screening strategy targeting inpatients 40 years and older were found to be low-cost and effective, which will help to find the missing millions of yet unaware patients and also accelerate the elimination of HCV in China. Keywords: Hepatitis C virus, Screening, Hospital, Positive rate
Background Hepatitis C virus (HCV) poses a serious public health problem due to its global prevalence. Acute HCV infection is often neglected because it manifests as only mild discomfort or can be asymptomatic, with gradual progression to severe liver disease, which ultimately lead to death. The absolute burden of viral hepatitis and related deaths increased tremendously between 1990 and 2013 [1]. Moreover, the HCV-related disease burden continues to increase as the infected population advances to * Correspondence: [email protected] 1 Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin 130021, China Full list of author information is available at the end of the article
late-stage liver disease [2]. A modeling study has indicated that improving the diagnosis and treatment rates of hepatitis C infection has
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