Opt-out HIV and Hepatitis C Testing at the Dallas County Jail: Uptake, Prevalence, and Demographic Characteristics of Testers.

Opt-out HIV and Hepatitis C Testing at the Dallas County Jail: Uptake, Prevalence, and Demographic Characteristics of Testers. Public Health Rep. 2017 Jan 01;:33354917732755 Authors: de la Flor C, Porsa E, Nijhawan AE Abstract Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection are common in the criminal justice system. We offered opt-out HIV/HCV testing at the Dallas County Jail during intake from June 2015 to November 2016, after which testing was integrated into routine phlebotomy processes. The uptake of testing increased from 12.9% (118/915) in June 2015 to 80.5% (269/334) in January 2016. HIV was confirmed in 1.0% (30/3155) of inmates; 6 were new diagnoses and all were linked to care. HCV antibody positivity was found in 16.4% (500/4042) of inmates. Sixty percent (155/258) of HCV-positive inmates born between 1945 and 1965 (ie, baby boomers) were non-Hispanic black, whereas 56.2% (136/242) born after 1965 were non-Hispanic white. Testing only baby boomers would have missed approximately half of HCV infections, predominantly among young, non-Hispanic white people. Future efforts should expand HIV and HCV testing in jails, as it is feasible, acceptable, and increases prevention and engagement in care for a high-prevalence, hard-to-reach population. PMID: 29045799 [PubMed - as supplied by publisher]
Source: Public Health Reports - Category: International Medicine & Public Health Tags: Public Health Rep Source Type: research

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Publication date: Available online 18 January 2019Source: Molecular Genetics and MetabolismAuthor(s): Ashwani K. SingalAbstractPorphyria cutanea tarda (PCT) is the most common human porphyria, due to hepatic deficiency of uroporphyrinogen decarboxylase (UROD), which is acquired in the presence of iron overload and various susceptibility factors, such as alcohol abuse, smoking, hepatitis C virus (HCV) infection, HIV infection, iron overload with HFE gene mutations, use of estrogens, and UROD mutation. Patients with familial or type II PCT due to autosomal dominant UROD mutation also require other susceptibility factors, as ...
Source: Molecular Genetics and Metabolism - Category: Genetics & Stem Cells Source Type: research
Abstract Hepatitis C virus (HCV) infection often leads to chronic hepatitis that can progress to liver cirrhosis and hepatocellular carcinoma (HCC). Although HCV infection is expected to decrease due to the high rate of HCV eradication via the rapid dissemination and use of directly acting antivirals, HCV infection remains a leading cause of HCC. Although the mechanisms underlying the HCC development are not fully understood, oxidative stress is present to a greater degree in HCV infection than in other inflammatory liver diseases and has been proposed as a major mechanism of liver injury in patients with chronic ...
Source: Free Radical Biology and Medicine - Category: Biology Authors: Tags: Free Radic Biol Med Source Type: research
CONCLUSIONS: Non-targeted opt-out HCV testing can be successfully implemented in an ED setting. A number of patients diagnosed were outside traditional risk groups. Once diagnosed, an ED population may be difficult to engage in care, but a structured interdisciplinary program can successfully link patients to HCV treatment. This article is protected by copyright. All rights reserved. PMID: 29851238 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Acad Emerg Med Source Type: research
CONCLUSION: We demonstrated a high burden of HCV exposure or infection among a small urban cohort of MSM who inject drugs. We recommend active screening of MSM (especially those who report drug use) for HCV, and the development of referral networks for access to treatment. PMID: 29262967 [PubMed - in process]
Source: South African Medical Journal - Category: African Health Tags: S Afr Med J Source Type: research
Abstract The prevalence of type 2 diabetes is increasing in epidemic proportions worldwide. Evidence suggests body iron overload is frequently linked and observed in patients with type 2 diabetes. Body iron metabolism is based on iron conservation and recycling by which only a part of the daily need is replaced by duodenal absorption. The principal liver-produced peptide called hepcidin plays a fundamental role in iron metabolism. It directly binds to ferroportin, the sole iron exporter, resulting in the internalization and degradation of ferroportin. However, inappropriate production of hepcidin has been shown to...
Source: Acta Haematologica - Category: Hematology Authors: Tags: Acta Haematol Source Type: research
We present a female patient with end-stage renal disease, bullous skin lesions affecting mainly sun-exposed areas, and high ferritin levels. She also had hepatitis C. Her serum porphyrin panel was suggestive of porphyria cutanea tarda. Skin biopsy excluded inflammatory pathologies. Phlebotomy during each hemodialysis, continuation of darbepoetin, and avoidance of any further doses of intravenous iron, with close monitoring of hemoglobin, resulted in a gradual drop in ferritin level and improvement of the skin lesions. PMID: 28988591 [PubMed]
Source: Advances in Peritoneal Dialysis. Conference on Peritoneal Dialysis - Category: Urology & Nephrology Tags: Adv Perit Dial Source Type: research
This article is protected by copyright. All rights reserved.
Source: Hepatology - Category: Internal Medicine Authors: Tags: Clinical Perspectives in Hepatology Source Type: research
Conclusions HCV transmission was confirmed among residents of facility A. The exact mode of transmission was not able to be identified, but infection control lapses were likely responsible. This outbreak highlights the importance of prompt reporting and investigation of incident HCV infection and the need for adherence to basic infection control procedures by health care personnel.
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
AbstractPorphyrias are a group of metabolic disorders, which result from a specific abnormality in one of the eight enzymes of the heme biosynthetic pathway. These have been subdivided based on the predominant site of enzyme defect into hepatic and erythropoietic types and based on clinical presentation into acute neurovisceral and cutaneous blistering porphyrias. This review focuses on hepatic porphyrias, which include acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), aminolevulinic acid dehydratase deficiency porphyria (ADP), and porphyria cutanea tarda (PCT). Of these, AIP an...
Source: Indian Journal of Gastroenterology - Category: Gastroenterology Source Type: research
We describe a 25‐year‐old man with polycythemia vera who became resistant to hydroxyurea after 6 years of treatment, requiring therapeutic phlebotomy procedures with increasing frequency for elevated hemoglobin and hematocrit levels. PEG‐IFN alfa‐2a was then initiated at 90 μg subcutaneously once/week and was progressively increased to 180 μg/week over the next 11 months, with normalization of his hemoglobin and hematocrit. The patient then developed hypercalcemia with low parathyroid hormone, parathyroid hormone–related protein, and 25‐hydroxyvitamin D levels, and high 1,25‐dihydroxyvitamin D and a...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: Case Report Source Type: research
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