Opt-out testing for blood-borne viruses in primary care: a multicentre, prospective study

O’Kelly, Mark; Byrne, David; Naughten, Edward; Bergin, Colm; Williams, Caroline

doi:10.3399/bjgp16x685225

Cited by 15 publications

(17 citation statements)

References 10 publications

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“…The searches yielded 15 004 records after de‐duplication; after full‐text review, 368 studies were included in the overall systematic review (Figure ). Of the 368 studies, 130 are described in this paper, exploring interventions and feasibility of HIV testing in health care settings in Europe, including 84 peer‐reviewed articles and 46 conference proceedings (Table ) .…”

Section: Resultsmentioning

confidence: 99%

“…Other testing strategies included routine testing (n = 32) [20,21,24,25,32,35,36,43,61,64,65,69,74,77,78,[92][93][94][95][96]98,104,111,[115][116][117]120,125,130,135,137,147], provision of HIV testing as a component of an integrated testing programme (n = 29) [22,23,32,35,37,38,47,50,52,55,62,63,70,72,74,79,[92][93][94]96,...…”

Section: Testing Provision Strategiesmentioning

confidence: 99%

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HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

et al. 2019

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Objectives Despite the availability of HIV testing guidelines to facilitate prompt diagnosis, late HIV diagnosis remains high across Europe. The study synthesizes recent evidence on HIV testing strategies adopted in health care settings in the European Union/European Economic Area (EU/EEA). Methods Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed and systematic searches were run in five databases (2010–2017) to identify studies describing HIV testing interventions in health care settings in the EU/EEA. The grey literature was searched for unpublished studies (2014–2017). Two reviewers independently performed study selection, data extraction and critical appraisal. Results One hundred and thirty intervention and/or feasibility studies on HIV testing in health care settings were identified. Interventions included testing provision (n = 94), campaigns (n = 14) and education and training for staff and patients (n = 20). HIV test coverage achieved through testing provision varied: 2.9–94% in primary care compared to 3.9–66% in emergency departments. HIV test positivity was lower in emergency departments (0–1.3%) and antenatal services (0–0.05%) than in other hospital departments (e.g. inpatients: 0–5.3%). Indicator condition testing programmes increased HIV test coverage from 3.9–72% before to 12–85% after their implementation, with most studies reporting a 10–20% increase. There were 51 feasibility and/or acceptability studies that demonstrated that HIV testing interventions were generally acceptable to patients and providers in health care settings (e.g. general practitioner testing acceptable: 77–93%). Conclusions This review has identified several strategies that could be adopted to achieve high HIV testing coverage across a variety of health care settings and populations in the EU/EEA. Very few studies compared the intervention under investigation to a baseline, but, where this was assessed, data suggested increases in testing.

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Section: Resultsmentioning

confidence: 99%

Section: Testing Provision Strategiesmentioning

confidence: 99%

HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

et al. 2019

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“…The majority of people with CHB live in countries that now have national viral hepatitis plans [11]. Many of these plans encompass population-specific communications campaigns to improve awareness and promote testing [12]; community-based programs to provide testing and linkage to care to under-served and high-risk communities [13][14][15]; and pilot projects integrating HBV testing and care into health systems to improve the capacity of primary care providers to test and manage people with CHB [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

The Lived Experience of Chronic Hepatitis B: A Broader View of Its Impacts and Why We Need a Cure

Block

Wang

et al. 2020

Viruses

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Chronic hepatitis B (CHB) is one of the most widespread liver diseases in the world. It is currently incurable and can lead to liver cirrhosis and cancer. The considerable impacts on society caused by CHB through patient mortality, morbidity, and economic loss are well-recognised in the field. This is, however, a narrow view of the harms, given that people living with CHB can be asymptomatic for the majority of their life-long infection. Of less-appreciated importance are the psychosocial harms, which can continue throughout an affected person’s lifetime. Here we review the broad range of these impacts, which include fear and anxiety; financial loss and instability; stigma and discrimination; and rejection by society. Importantly, these directly affect patient diagnosis, management, and treatment. Further, we highlight the roles that the research community can play in taking these factors into account and mitigating them. In particular, the development of a cure for hepatitis B virus infection would alleviate many of the psychosocial impacts of CHB. We conclude that there should be a greater recognition of the full impacts associated with CHB to bring meaningful, effective, and deliverable results to the global community living with hepatitis B.

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“…This should be enhanced for example through increasing awareness among physicians and decreasing barriers e.g. through on-site testing [18] or opt-out testing [19].…”

Section: Discussionmentioning

confidence: 99%

High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing

et al. 2020

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Background: In Germany, risk of hepatitis C virus (HCV) infection is highest among people who inject drugs (PWID). New injectors (NI) are particularly vulnerable for HCV-acquisition, but little is known about health seeking behaviour and opportunities for intervention in this group. We describe characteristics, HCV prevalence, estimated HCV incidence and awareness of HCV-status among NIs and missed opportunities for hepatitis C testing. Methods: People who had injected drugs in the last 12 months were recruited into a cross-sectional serobehavioural study using respondent-driven sampling in 8 German cities, 2011-2014. Data on sociodemographic characteristics, previous HCV testing and access to care were collected through questionnaire-based interviews. Capillary blood was tested for HCV. People injecting drugs < 5 years were considered NI. Results: Of 2059 participants with available information on duration of injection drug use, 232 (11% were NI. Estimated HCV incidence among NI was 19.6 infections/100 person years at risk (95% CI 16-24). Thirty-six percent of NI were HCV-positive (thereof 76% with detectable RNA) and 41% of those HCV-positive were unaware of their HCV-status. Overall, 27% of NI reported never having been HCV-tested. Of NI with available information, more than 80% had attended low-threshold drug services in the last 30 days, 24% were released from prison in the last 12 months and medical care was most commonly accessed in hospitals, opioid substitution therapy (OST)-practices, practices without OST and prison hospitals. Conclusion: We found high HCV-positivity and low HCV-status awareness among NI, often with missed opportunities for HCV-testing. To increase early diagnosis and facilitate treatment, HCV-testing should be offered in all facilities, where NI can be reached, especially low-threshold drug services and addiction therapy, but also prisons, hospitals and practices without OST.

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Opt-out testing for blood-borne viruses in primary care: a multicentre, prospective study

Cited by 15 publications

References 10 publications

HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

HIV testing strategies employed in health care settings in the European Union/European Economic Area (EU/EEA): evidence from a systematic review

The Lived Experience of Chronic Hepatitis B: A Broader View of Its Impacts and Why We Need a Cure

High prevalence of hepatitis C virus infection and low level of awareness among people who recently started injecting drugs in a cross-sectional study in Germany, 2011–2014: missed opportunities for hepatitis C testing

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