Abstract:Background and Aims:The World Health Organization's hepatitis C virus (HCV) elimination strategy recognizes the need for interventions that identify populations most affected by infection. The emergency department (ED) has been suggested as a setting for HCV screening. The study objective was to explore the health and economic impact of HCV screening in the ED setting.
Methods:We used a microsimulation model to conduct a cost-utility analysis evaluating two ED setting-specific strategies: no screening, and scr… Show more
“…According to recent reports, viral hepatitis will be eliminated until 2030. In this regard, the number of infected individuals and associated mortality should be reduced by 90 % and 65 %, respectively ( Mendlowitz et al, 2020 ). Rabbit hemorrhagic disease (RHD) is a greatly lethal viral infection in rabbits characterized by severe necrotizing hepatitis and disseminated intravascular coagulation in the liver, kidney and spleen( Beller et al, 1969 ).…”
Section: Melatonin and Viral Infections: Cellular Signaling And Theramentioning
Highlights
Viral infections are serious life-threatening and problematic human diseases.
Melatonin can regulate human immune responses.
Melatonin could be beneficial against different viral complications.
In combination with other drugs, melatonin may play therapeutic role in COVID-19.
“…According to recent reports, viral hepatitis will be eliminated until 2030. In this regard, the number of infected individuals and associated mortality should be reduced by 90 % and 65 %, respectively ( Mendlowitz et al, 2020 ). Rabbit hemorrhagic disease (RHD) is a greatly lethal viral infection in rabbits characterized by severe necrotizing hepatitis and disseminated intravascular coagulation in the liver, kidney and spleen( Beller et al, 1969 ).…”
Section: Melatonin and Viral Infections: Cellular Signaling And Theramentioning
Highlights
Viral infections are serious life-threatening and problematic human diseases.
Melatonin can regulate human immune responses.
Melatonin could be beneficial against different viral complications.
In combination with other drugs, melatonin may play therapeutic role in COVID-19.
“… 10 With HCV testing becoming more affordable and curative therapy now available, the benefit of early detection with linkage-to-treatment in individuals with chronic infection likely outweighs the cost of increased testing. 21 …”
Section: Discussionmentioning
confidence: 99%
“…10 With HCV testing becoming more affordable and curative therapy now available, the benefit of early detection with linkage-to-treatment in individuals with chronic infection likely outweighs the cost of increased testing. 21 To assess the impact of provider bias on screening practices we compared demographic proportions of screened individuals before and after the implementation of the BPA. In the pre-BPA period, individuals tested were more likely to be male (60%).…”
Introduction
In 2019 the United States Preventive Services Task Force (USPSTF) released draft guidelines recommending universal hepatitis C virus (HCV) screening for individuals aged 18–79. We aimed to assess the efficacy of an emergency department-based HCV screening program, by comparing screening practices before and after its implementation.
Methods
We performed a retrospective cohort analysis of two temporally matched, 11-month study periods, corresponding to before and after the implementation of a best practice advisory (BPA). Patients were screened for anti-HCV antibody (Ab), and positive results were followed by HCV viral load (VL) testing. The primary implementation outcome was ED testing volume (number of tests performed/month). The primary screening outcomes were the seroprevalence of anti-HCV Ab and HCV VL. We describe data with simple descriptive statistics.
Results
The median age of patients was similar between periods (pre: 50 years [interquartile range [IQR] 34–62], post: 47 years [IQR 33–59]). Patients screened were more likely to be males in the pre-BPA period (Male, pre: 60%, post: 49%). During the pre-BPA study period, a total of 69,604 patients were seen in the ED, and 218 unique patients were screened for HCV (mean 19.8 tests/month). During the post-BPA study period, a total of 68,225 patients were seen in the ED, and 14,981 unique patients were screened for HCV (mean 1361.9 tests/month). Anti-HCV Ab seroprevalence was 23% (51/218) and 9% (1340/14,981) in the pre-BPA and post-BPA periods, respectively. In the pre-BPA period, six patients with a positive anti-HCV Ab level had follow-up VL testing (detectable in three). In the post-BPA period, reflex VL testing was performed in most patients (91%, 1225/1,340), and there were 563 patients with detectable VLs, indicating active infection.
Conclusion
Our study shows that using a universal BPA-driven screening protocol can dramatically increase the number of patients screened for HCV and increase the number of new HCV diagnoses.
“…World Health Organization (WHO) aims to eliminate viral hepatitis until 2030, which means the number of newly infected subjects, and related mortality should be reduced by 90% and 65%, respectively. This program covers various approaches, including diagnosis, treatment, vaccination against hepatitis B virus (HBV), preventing transmission from mother to child, and blood safety [11,12]. Although scientists have recently focused on developing effective drugs and vaccines for COVID-19, other diseases and pathogens should be considered, as well [13].…”
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