Related Experiment Video
Updated: May 2, 2026
Dried Blood Spots - Preparing and Processing for Use in Immunoassays and in Molecular Techniques
Published on: March 13, 2015
Case-finding for hepatitis C in primary care: a mixed-methods service evaluation
Shivani Datta1, Jeremy Horwood, Matthew Hickman
1Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol.
Insights
Many at-risk individuals, including people who inject drugs (PWID) and immigrants, remain untested for hepatitis C virus (HCV). General practitioners (GPs) face barriers to testing, highlighting the need for improved case-finding strategies.
Area of Science:
- Hepatology
- Public Health
- General Practice
Background:
- Hepatitis C virus (HCV) infection is often asymptomatic, leading to delayed diagnosis and severe liver complications like cirrhosis, liver failure, and cancer.
- People who inject drugs (PWID) and immigrants from high-prevalence regions are key at-risk populations for HCV.
- Despite increased HCV-related hospitalizations, a significant proportion of chronically infected individuals remain undiagnosed.
Purpose of the Study:
- To identify patients at risk for hepatitis C using routine general practitioner (GP) data.
- To determine the percentage of at-risk patients who have not been tested for HCV.
- To explore GPs' perspectives and barriers concerning HCV testing in primary care.
Main Methods:
- A mixed-methods service evaluation was conducted in six NHS general practices in Bristol.
- Patients at risk of HCV were identified using a density-based selection of PWID.
- Data on HCV test results were obtained from the Health Protection Agency laboratory, and 17 GPs were interviewed regarding their testing practices and views.
Main Results:
- Out of 3765 identified at-risk patients, 3051 (81%) had no recorded test result, including 53% of PWID and 93% of the 'ethnicity' group.
- While all GPs reported routinely testing PWID, most tested immigrants for HIV and hepatitis B more frequently than for HCV.
- Identified barriers to HCV testing included failure to inquire about risk factors, competing clinical priorities, challenges in accessing patient data, and patient lifestyle factors.
Conclusions:
- Computerized prompts and enhanced GP education are necessary to improve HCV testing rates among at-risk populations.
- Integrating questions about country of origin and drug use into new-patient questionnaires could enhance HCV case-finding efforts.
Background:
Hepatitis C is often asymptomatic, presenting with liver failure and cancer decades after infection. People who inject drugs (PWID) and immigrant populations from countries with a moderate-to-high prevalence of hepatitis C virus (HCV) are the main risk groups. Deaths and hospital admissions due to HCV cirrhosis tripled between 1998 and 2010, but the majority of people with chronic HCV are unaware of it.
Aim:
To identify patients at risk of developing hepatitis C using routine GP data, to determine the proportion not tested, and to explore GPs' views regarding testing.
Design And Setting:
Mixed-methods service evaluation (density-based selection of PWID) in six NHS practices in Bristol.
Method:
Patients at risk of HCV were identified. The Health Protection Agency laboratory (now part of Public Health England) provided test results. Semi-structured interviews with 17 GPs were audiorecorded and thematic analyses conducted on anonymised transcripts.
Results:
Of 3765 patients identified as being at risk of developing hepatitis C, 3051 (81%) had no test result, including 53% of PWID and 93% of the 'ethnicity' group. All GPs said they usually test PWID. Most GPs test for HIV and hepatitis B in immigrants more often than they test for HCV. Barriers to testing included not questioning patients about risk factors, competing priorities, the chaotic lifestyle of PWID, difficulty extracting information from computerised records, and forgetting to address HCV.
Conclusion:
Computer prompts and GP education on whom to test are warranted. Ensuring that country of origin and drug use is included on the new-patient questionnaire might also aid case-finding for HCV.
More Related Videos
05:56Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
Published on: August 29, 2025
12:24A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Related Concept Videos
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:25Hepatitis
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment: