Enfermedades infecciosas y microbiologia clinica (English ed.) · 2025
Detection of previously undiagnosed or lost to follow-up hepatitis C infections by implementing an opportunistic screening in an emergency department.
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Llopis-Roca Ferran, Suárez-Lledó Ana, Rebollo-Curbelo Alexis, Calatayud-Samper Laura, Urdániz-Fraguas María Jesús, Márquez-Rodríguez Francisca, Castellote-Alonso José, Carrodeguas Alba, González-Sánchez José Luis, Malchair Pierre
Аннотация
OBJECTIVES: This study aimed to evaluate the effectiveness of an opportunistic hepatitis C virus (HCV) screening program in identifying new cases and ensuring their follow-up (linkage to care) in our health area.
METHODS: We conducted a prospective study from June 2023 to May 2024 in an emergency department (ED) of Catalonia (Spain), screening patients aged 30-70 years who had blood samples collected as part of routine clinical practice. Patients with positive anti-HCV antibodies were confirmed with HCV RNA testing, and those with active infection were referred to the gastroenterology department for care.
RESULTS: Out of 15,245 eligible patients, 5184 were screened for HCV, marking a 192% increase compared to the previous year. Of total serologies, 3973 were requested in patients aged between 30-70 years and the rest by routine clinical practice. Anti-HCV antibodies were detected in 120 patients (3.02%), and 13 (0.33%) had active HCV infection. The mean age of viremic patients was 49.62 years and 76.92% were male. Identified risk factors included drug use (63.64%) and being from countries with high HCV prevalence (18.18%). Advanced liver fibrosis was found in 25% of patients.
CONCLUSIONS: Opportunistic screening in the ED significantly increased HCV testing and identified a higher prevalence of active infection compared to the general population. These findings support expanding screening guidelines to reach broader populations, improving early diagnosis and linkage to care for HCV.
METHODS: We conducted a prospective study from June 2023 to May 2024 in an emergency department (ED) of Catalonia (Spain), screening patients aged 30-70 years who had blood samples collected as part of routine clinical practice. Patients with positive anti-HCV antibodies were confirmed with HCV RNA testing, and those with active infection were referred to the gastroenterology department for care.
RESULTS: Out of 15,245 eligible patients, 5184 were screened for HCV, marking a 192% increase compared to the previous year. Of total serologies, 3973 were requested in patients aged between 30-70 years and the rest by routine clinical practice. Anti-HCV antibodies were detected in 120 patients (3.02%), and 13 (0.33%) had active HCV infection. The mean age of viremic patients was 49.62 years and 76.92% were male. Identified risk factors included drug use (63.64%) and being from countries with high HCV prevalence (18.18%). Advanced liver fibrosis was found in 25% of patients.
CONCLUSIONS: Opportunistic screening in the ED significantly increased HCV testing and identified a higher prevalence of active infection compared to the general population. These findings support expanding screening guidelines to reach broader populations, improving early diagnosis and linkage to care for HCV.