Introduction
Opportunistic hepatitis C virus (HCV) screening, taking advantage of laboratory analysis requested to patients for another clinical reasons, has shown to increase HCV detection. Here, we present the results for HCV detection from "Sureste sin C" microelimination program, which is run within Hospital Universitario del Sureste sanitary area in Madrid (Spain). This program includes HCV training at hospital level at different services and in primary care, advertisement on informative panels, automation of preoperative protocol and search of lost to follow-up patients.
Aims & Methods
In July 2021, this HCV micro-elimination program began in our sanitary area. This program was supported by Gilead (within Hospitals without C program). A key point was to favor HCV opportunistic screening at different hospital services, both medical surgical (preoperatory) and Emergency departments. Moreover, systematic HCV serology screening (automatization) was included in the surgical preoperative service. The effectiveness of the program was measured in terms of number of HCV-screening requests made between January-October 2019 (prior to the pandemic, first period) and January-October 2022 (second period).
Results
There were 3,709 requests for HCV serology (3,313 individual patients) in the first period, compared with 7,743 (6,902 individual patients) in the second period (109% increase). Divided by services, this increase was mainly due to the surgical services (251% increase), as a result of the automatic inclusion of HCV serology in the preoperative protocols, and in psychiatry (558% increase). In the medical area, the increase in the second period was 42%, being Gastroenterology, Internal Medicine, Pneumology and Oncology the services with greatest increase in requests. Regarding Emergency department, an increase in requests of 101% was observed. In total, 145 Anti-HCV positive patients were detected in the first period (prevalence 4.37%), 48 being viremic (1.44%), compared to 130 patients in the second period (prevalence 1.88%), 29 viremics (0.42%). Regarding only surgical services, there was a very significant increase in the number of positive serology in the second period (8 vs 45, 462% increase, prevalence 1.14%), as well as in the number of viremics (0 vs 5 patients, prevalence 0.12 %).
Conclusion
HCV serology automatization in the surgical preoperative protocol and the awareness and collaboration with other services to support opportunistic HCV screening, is an effective mechanism to achieve the objective of detecting infected patients within a hepatitis C micro-elimination program. Automatization in surgical preoperatory service has demonstrated to increase the detection of occult HCV infected patients.
Disclosure
This program was supported by Gilead (within Hospitals without C program).