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Ann Fam Med. 2018 Jan;16(1):21-27. doi: 10.1370/afm.2166.

Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing.

Author information

1
Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service (GGD) South Limburg, Heerlen, The Netherlands Jeanne.Heil@ggdzl.nl.
2
Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre, Maastricht, The Netherlands.
3
Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service (GGD) South Limburg, Heerlen, The Netherlands.
4
Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.

Abstract

PURPOSE:

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.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

KEYWORDS:

birth cohort screening; hepatitis B virus; hepatitis C virus; hidden population; hotspots; primary health care; public health

PMID:
29311171
PMCID:
PMC5758316
DOI:
10.1370/afm.2166
[Indexed for MEDLINE]
Free PMC Article

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