Increasing Birth Cohort Screening for Chronic Hepatitis C in a Primary Care Clinic with Panel Management

AbstractChronic hepatitis C affects millions of people worldwide and patients born between 1945 and 1965 are at elevated risk. Hepatitis C infection can lead to health complications including liver cirrhosis and hepatocellular carcinoma. Recent advancements in direct-acting antiviral treatments have placed the spotlight on primary care providers to identify undiagnosed patients with chronic hepatitis C for treatment and attaining a sustained-virologic response. Primary care providers do not routinely screen patients born between 1945 and 1965 for hepatitis C despite CDC recommendations. To evaluate the effectiveness of a hepatitis C screening protocol implemented in a primary care setting with no prior protocol. A multidisciplinary team was used to implement a hepatitis C screening protocol for patients born between 1945 and 1965 (birth cohort screening). A retrospective analysis was conducted to compare the rate of hepatitis C screening 2  years before and 2 years after the protocol was implemented. Frequency data were collected monthly and tracked in a run chart noting relevant events that affected screening. In the 2 years before the screening protocol began, 81 patients were screened (average = 3 per month); and in the 2 y ears after the intervention was implemented, a total of 637 patients were screened (average = 25 per month). The protocol was successful in increasing screening rates from 15 to 66% in the 2 years pos...
Source: Journal of Community Health - Category: International Medicine & Public Health Source Type: research

Related Links:

Authors: Stasi C, Sadalla S, Carradori E, Monti M, Petraccia L, Madia F, Gragnani L, Zignego AL Abstract BACKGROUND. New direct-acting antiviral drugs can eradicate hepatitis C virus (HCV) infection in over 90% of patients and can even reduce the risk of complications in advanced fibrosis/cirrhosis. The aims of this study were to evaluate 1) changes in fibrosis during and after antiviral treatment and 2) incidence of hepatocarcinoma and mortality in various fibrosis stages.METHODS. This is a longitudinal monocentric prospective study. Blood and instrumental examinations were evaluated at baseline, at the end of the...
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Authors: Raafat Rowida I, Eshra KA, El-Sharaby RM, Eissa R, Saied SM, Amer I, El Sharawy S Abstract BACKGROUND: As hepatocellular carcinoma (HCC) arising from chronic hepatitis C virus (HCV) infection in liver cirrhosis is a major problem in public health, early and rapid prediction of HCC is urgent. We hypothesised that a single nucleotide polymorphism in the Apa1 SNP in the vitamin D receptor may help diagnosis. METHODS: We recruited 3 groups: 80 HCC patients with HCV cirrhosis, 80 HCV cirrhotic patients free of HCC and 80 healthy controls. Apa1 rs7975232 SNP was detected by PCR- RFLP technique. Routine labor...
Source: British Journal of Biomedical Science - Category: Laboratory Medicine Tags: Br J Biomed Sci Source Type: research
Chronic hepatitis C virus (HCV) infection is a major public health threat, with an estimated 71 million individuals affected worldwide.[1] In 2015, it is estimated that only 20% of these individuals were aware of their HCV infection.[1] In 2016, approximately 13% of those aware of having chronic HCV infection were being treated.[2] Approximately 15 –30% of patients with chronic HCV infection will develop cirrhosis within 20 years[3] and, if left untreated, these patients are at risk for developing hepatic decompensation and hepatocellular carcinoma, ultimately leading to increased liver-related mortality.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research
Background/Aims: The course of hepatitis C infection (HCV) in patients with thalassemia has not been adequately studied and management has not been optimized. The current prospective longitudinal study assessed the clinical course, outcome, progression and management of recently acquired HCV in patients with transfusion dependent thalassemia major versus acute HCV without thalassemia.Methods: A well-characterized cohort of patients with thalassemia and recent HCV infection or recent HCV without thalassemia were enrolled and prospectively followed. The blood transfusion needs and chelating agents were determined. Liver func...
Source: Mediterranean Journal of Hematology and Infectious Diseases - Category: Hematology Source Type: research
CONCLUSIONS: The six serum miRNAs can be utilized as a surrogate and non-invasive biomarker for HCV-related HCC diagnosis. PMID: 31658041 [PubMed - as supplied by publisher]
Source: Cancer Biomarkers - Category: Cancer & Oncology Tags: Cancer Biomark Source Type: research
This study examined 196 patients for an estimation study (104 patients with HCC, 52 with liver cirrhosis and 40 with liver fibrosis) and 122 patients for the validation study (80 patients with HCC, 42 with liver cirrhosis). All patients were positive for hepatitis C virus. Four markers were measured: Midkine and thioredoxin using ELISA, 1-methyladenosine and 1-methylguanosine using a gas chromatography-mass spectrometry (GC-MS). The results were compared with alpha-fetoprotein (AFP). The performance of the model was estimated in BCLC, CLIP and Okuda staging systems of HCC. RESULTS: The model yielded high performance wi...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
OBJECTIVES: Our objective was to analyze, in a population treated for hepatitis C infection at a tertiary care treatment unit, the prevalence of comorbidities and extrahepatic manifestations, the range and degree of the clinical complexity and the associations between advanced liver disease and clinical variables. METHODS: Medical records from chronically infected hepatitis C patients seen at a dedicated treatment facility for complex cases in the Infectious Diseases Division of Hospital das Cl ínicas in Brazil were analyzed. Clinical complexity was defined as the presence of one or more of the following conditions:...
Source: Clinics - Category: General Medicine Source Type: research
Abstract BACKGROUND: Direct-acting antiviral agents (DAAs) are extremely effective in eradicating hepatitis C virus (HCV) in chronically infected patients. However, the protective role of the sustained virologic response (SVR) achieved by second- and third-generation DAAs against the onset of hepatocellular carcinoma (HCC) and mortality is less well established. AIM: To examine the occurrence of HCC or death from any cause in a retrospective-prospective study of patients treated with DAAs. METHODS: Patients were enrolled from a tertiary academic hospital center for liver disease management that collects ...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
AbstractDirect acting antiviral (DAA) treatments may reduce the elevated α fetoprotein (AFP), but data on how these treatments affect elevated AFP in patients with chronic hepatitis C (CHC) remain insufficient. In the present study, the frequency of baseline AFP elevations and their related factors, AFP dynamics during and after DAA treatment, and factors associated wit h AFP reduction was assessed. This retrospective study included 141 patients with CHC without hepatocellular carcinoma who received DAA and achieved sustained virological response. The details are as follows: mean post-treatment follow-up was 99 weeks...
Source: Frontiers of Medicine - Category: General Medicine Source Type: research
We appreciate the correspondence of Lapointe-Shaw et al. on our study ‘‘Time to decompensated cirrhosis and hepatocellular carcinoma after an HBV or HCV notification: A population-based study”.1 They make important points in relation to possible sources of bias in the evaluation of late hepatitis C virus (HCV) diagnosis. We have therefore undertaken further anal yses to clarify the role of monitoring trends in “late HCV diagnosis” and to highlight key differences in the epidemiology of HCV and population-level HCV screening in New South Wales (NSW) and Ontario.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Letter to the Editor Source Type: research
More News: Cancer & Oncology | Carcinoma | Cirrhosis | Hepatitis | Hepatitis C | Hepatocellular Carcinoma | International Medicine & Public Health | Liver | Liver Cancer | Primary Care | Study | Urology & Nephrology | Virology