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J Public Health (Oxf). 2012 Mar;34(1):14-23. doi: 10.1093/pubmed/fdr097. Epub 2011 Dec 2.

Identifying former injecting drug users infected with hepatitis C: an evaluation of a general practice-based case-finding intervention.

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1
Health Protection Scotland, Clifton House, Clifton Place, Glasgow G3 7LN, UK. beth.cullen@nhs.net

Abstract

BACKGROUND:

In Scotland, a general practice-based case-finding initiative, to diagnose and refer hepatitis C virus (HCV) chronically infected former injecting drug users (IDUs), was evaluated.

METHODS:

Testing was offered in eight Glasgow general practices in areas of high deprivation and high HCV and IDU prevalence to attendees aged 30-54 years with a history of IDU. Test uptake and diagnosis rates were compared with those in eight demographically similar control practices.

RESULTS:

Of 422 eligible intervention practice attendees, 218 (52%) were offered an HCV test and, of these, 121 (56%) accepted. Poor venous access in 13 individuals prevented testing. Of 105 tested, 70% (74/105) were antibody positive of which 58% (43/74) were RNA positive by PCR. Of 43 chronically infected individuals identified in intervention practices, 22 (51%) had attended specialist care within 30 months of the study, while 9 (21%) had defaulted. In control practices, 8 (22%) of 36 individuals tested were antibody positive. Test uptake and case yield were approximately 3 and 10 times higher in intervention compared with control practices, respectively.

CONCLUSIONS:

Targeted case-finding in primary care demonstrated higher test uptake and diagnosis rates; however, to optimize diagnosis and referral of chronically infected individuals, alternative means of testing (e.g. dried blood spots) and retention in specialist care (e.g. outreach services) must be explored.

PMID:
22138489
DOI:
10.1093/pubmed/fdr097
[Indexed for MEDLINE]
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