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- Title
Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing.
- Authors
Heil, Jeanne; Hoebe, Christian J. P. A.; Cals, Jochen W. L.; ter Waarbeek, Henriëtte L. G.; van Loo, Inge H. M.; Dukers-Muijrers, Nicole H. T. M.
- Abstract
<bold>Purpose: </bold>Both chronic hepatitis C (HCV) and B virus (HBV) infections are generally asymptomatic, and many remain undetected or are diagnosed at a late stage. Studies that evaluate best practice hepatitis testing strategies are needed to better detect this hidden population.<bold>Methods: </bold>In this prospective cohort study, we aimed to determine the diagnostic yield (test uptake and rate of positive test results) of a combined public health and primary care birth cohort testing strategy in detecting hidden cases of HCV and HBV infections. We invited all patients aged between 40 and 70 years (n = 6,743) registered with 11 family practices serving 2 higher prevalence areas, or hotspots (ie, estimated HCV prevalence of 1%; national estimated prevalence is 0.1-0.4%), in the south of the Netherlands.<bold>Results: </bold>Test uptake was 50.9% (n = 3,434 patients). No active or chronic HCV infection was detected: 0.00% (95% CI, 0.00%-0.11%). Positive test rates were 0.20% (95% CI, 0.08%-0.42%) for anti-HCV (n = 7), 0.26% (95% CI, 0.12%-0.50%) for hepatitis B surface antigen (n = 9), and 4.14% (95% CI, 3.49%-4.86%) for antihepatitis B core (n = 142).<bold>Conclusions: </bold>This best practice testing strategy was effective in achieving a high test uptake. It completely failed, however, to detect hidden chronic HCV infections and is not recommended for countries with a low prevalence of the disease.
- Subjects
HEPATITIS B; HEPATITIS C diagnosis; DIAGNOSIS methods; PUBLIC health; PRIMARY care; COHORT analysis; DIAGNOSIS
- Publication
Annals of Family Medicine, 2018, Vol 16, Issue 1, p21
- ISSN
1544-1709
- Publication type
journal article
- DOI
10.1370/afm.2166