Background
The World Health Organization (WHO) has set the goal of eradicating the Hepatitis C Virus (HCV) by 2030. The prevalence of active HCV infection in Spain is 0.2% but there are patients with silent infection who are unaware of their serologic status. Their detection through screening strategies is essential and Emergency departments (ED) may provide an opportunity for HCV screening.
Our main objective is to develop and consolidate a multidisciplinary screening program in our ED, detect patients with silent infection and link them to the healthcare system.
Methods
The screening program was carried out in the ED of our university hospital which attends around 130,000 emergencies/year. Our target population was patients aged between 30 and 70 years for whom an analysis was requested according to usual clinical practice. The ED created a circuit to communicate and link those with a positive viral load (PVL) to a Gastroenterology consultation.
We provided ongoing training and awareness on the importance of screening and developed a preconfigured HCV serology request. We are working with the IT department to automate the process.
Results
The screening program began on June 1, 2023. In the first 18 months we requested 6,390 serologies achieving 27,21% of the objective. Of them, 189 (2,96%) were positive, and 23 (0,36%) with PVL. There was a history of intravenous or inhaled drug abuse in 12 patients (52%). We linked 20 of 23 (87%) patients with a PVL to a first Gastroenterology consultation.
Conclusion
The prevalence of patients with active HCV infection in our ED is higher than the overall prevalence recorded in Spain, which demonstrates the importance of screening in ED.
Up to 87% of patients with PVL have been linked to the Gastroenterology consultation.
We have tested 1 in 4 target patients, so it is essential to automate the process. |