Awareness of infection, knowledge of hepatitis C, and medical follow-up among individuals testing positive for hepatitis C: National Health and Nutrition Examination Survey 2001-2008

Denniston, Maxine M.; Klevens, R. Monina; McQuillan, Geraldine M.; Jiles, Ruth

doi:10.1002/hep.25556

Cited by 331 publications

(301 citation statements)

References 12 publications

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“…We used ten hepatitis survey questions adapted from the NHANES follow-up questionnaire for hepatitis C to create the India Hepatitis Knowledge Index (IHKI) [11]. These ten questions assessed patient knowledge of hepatitis disease transmission, natural history, treatment, and prevention options.…”

Section: Description Of Study Variables India Hepatitis Knowledge Indexmentioning

confidence: 99%

Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India

et al. 2016

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Background Patient knowledge about chronic diseases increases health-promoting behaviors and improves clinical outcomes. We assessed this association for patients with chronic viral hepatitis. Methods Untreated patients chronically infected with HBV (n = 500) or HCV (n = 500) were enrolled at 19 centers across India. A survey, adapted from the US CDC National Health and Nutrition Examination Survey (NHANES) questionnaire, was administered at a single visit to assess HBV/HCV knowledge, community disease awareness, treatment quality, and healthcare barriers. We developed the India Hepatitis Knowledge Index (IHKI), where a higher IHKI score (range 0-10) indicates increased hepatitis knowledge. Multivariate regression models evaluated demographic and disease factors. Results The overall mean IHKI score was 5.6 out of 10, with higher scores among patients with HBV (5.9) than HCV (5.3); p \ 0.001. In HBV patients lower IHKI was associated with shorter disease duration, government clinic attendance (p \ 0.0001), fewer personal experiences with HBV (p \ 0.0001), and residing in northern India. Among HCV patients, lower IHKI was associated with shorter disease duration, community (p \ 0.0001) and government clinic attendance (p \ 0.0001), and fewer personal experiences with HCV (p \ 0.0001). Among HBV patients, IHKI was independently associated with disease severity as assessed by MELD score, albumin, and APRI. This association was strongest for HBV patients with elevated ALT and HBV DNA [2000 IU/ml. Among HCV patients, IHKI results had no significant associations with disease severity. Conclusions The association of IHKI with disease underscores the need to understand connections between hepatitis knowledge and progression and may guide efforts to address patient education and awareness of chronic viral hepatitis in India.

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Section: Description Of Study Variables India Hepatitis Knowledge Indexmentioning

confidence: 99%

Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India

et al. 2016

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“…1 Furthermore, of the estimated 4.3% of the population born in the 1950s who were infected, 50% were unaware of their status. 2,3 Currently in Canada, screening recommendations for HCV are based on an individual assessment of risk rather than the patient's age or year of birth. 4 The Canadian Health Measures Survey, a nationally representative household survey, estimated the seroprevalence of HCV for 2007-2011 to be 0.5% (95% confidence interval [CI] 0.3%-0.9%), with only 30% of those people (95% CI 16%-51%) aware of their infection.…”

Section: Researchmentioning

confidence: 99%

Historical trends and projected hospital admissions for chronic hepatitis C infection in Canada: a birth cohort analysis

2014

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Background:Much of the recent increase in hospital admission rates and mortality associated with hepatitis C in Canada is believed to be because of a higher prevalence of hepatitis C virus infection among those born between 1945 and 1965 (the baby boomer generation). We explored the effects of birth cohort on the rates of and projected trends in hospital admissions associated with hepatitis C. Methods:The hospital records of 17 344 inpatients with a diagnosis of chronic hepatitis C and liver disease, including liver cancer, were extracted from the Canadian Discharge Abstract Database for April 2004 to March 2011. For each 5-year birth cohort from 1915 to 1984, regression analysis was used to estimate the temporal trends associated with the average age of the cohort during the study period. Future hospital admissions were predicted based on the assumption that past trends would continue.Results: Hospital admissions associated with hepatitis C and liver disease increased an average of 6.0% (95% confidence interval [CI] 4.4%-7.7%) a year over the study period. As of 2010, hospital admission rates were highest for the 1950-1954 and 1955-1959 birth cohorts, at 17.6 (95% CI 13.2-23.5) and 13.7 (95% CI 10.3-18.2) times the rate for the 1970-1974 birth cohort. The corresponding same-age rate ratios predicted under a status quo scenario were 3.6 (95% CI 2.3-4.9) and 3.4 (95% CI 2.1-4.7). Same-age rate ratios were significantly higher for the four 5-year birth cohorts between 1950 and 1969 compared with other birth cohorts.Interpretation: Hospital admissions associated with chronic hepatitis C and liver disease were significantly higher for the 1950-1954 and 1955-1959 birth cohorts than for most other birth cohorts. Without further interventions, the disease burden associated with hepatitis C will continue to increase for most birth cohorts, likely peaking after age 70 years. The substantial disease burden emerging in younger birth cohorts should be monitored Abstract E140CMAJ OPEN, 2(3) ResearchCMAJ OPEN people who had tested positive for HCV compared with those who had tested negative.

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“…4 Early diagnosis and treatment can prevent HCV transmission and reduce HCV-related morbidity and mortality. 5,6 However, 50-75 % of chronically infected individuals are unaware of their infections and will not benefit from these interventions [7][8][9] ; many are diagnosed when presenting with advanced liver disease. Advances in HCV treatments can now cure more than 90 % of chronically infected individuals using interferonfree, short-term, well-tolerated regimens.…”

Section: Introductionmentioning

confidence: 99%

Results from a Geographically Focused, Community-Based HCV Screening, Linkage-to-Care and Patient Navigation Program

et al. 2015

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BACKGROUND: Many of the five million Americans chronically infected with hepatitis C (HCV) are unaware of their infection and are not in care. OBJECTIVE: We implemented and evaluated HCV screening and linkage-to-care interventions in a community setting. DESIGN: We developed a comprehensive, communitybased HCV screening and linkage-to-care program in a medically underserved neighborhood with high rates of HCV infection in Philadelphia, Pennsylvania. We provided patient navigation services to enroll uninsured patients in insurance programs, facilitate referrals from primary care physicians and link patients to an HCV infectious disease specialist with intention to treat and cure. PATIENTS: Philadelphia residents were recruited through street outreach. MAIN MEASURES: We measured anti-HCV seroprevalence and diagnosis, linkage and retention in care outcomes for chronically infected patients. KEY RESULTS: We screened 1,301 participants for HCV; anti-HCV seroprevalence was 3.9 % and 2.8 % of all patients were chronically infected. Half of chronically infected patients were newly diagnosed; the remaining patients were aware of infection but not in care. We provided confirmatory RNA testing and results, assisted patients with attaining insurance and linked most chronically infected patients to a primary care provider. The biggest barrier to retaining patients in care was obtaining referrals for subspecialty providers; however, we obtained referrals for 64 % of chronically infected participants and have retained most in subspecialty HCV care. Several have commenced treatment. CONCLUSIONS: Non-clinical screening programs with patient navigator services are an effective means to diagnose, link, retain and re-engage patients in HCV care. Eliminating referral requirements for subspecialty care might further enhance retention in care for patients chronically infected with HCV.KEY WORDS: hepatitis C; HCV screening; community-based screening; patient navigation; continuum of care. J Gen Intern Med 30(7):950-7

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Awareness of infection, knowledge of hepatitis C, and medical follow-up among individuals testing positive for hepatitis C: National Health and Nutrition Examination Survey 2001-2008

Cited by 331 publications

References 12 publications

Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India

Correlates of disease-specific knowledge among patients with chronic hepatitis B or hepatitis C infection in India

Historical trends and projected hospital admissions for chronic hepatitis C infection in Canada: a birth cohort analysis

Results from a Geographically Focused, Community-Based HCV Screening, Linkage-to-Care and Patient Navigation Program

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