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Author Spotlight: Advancements and Challenges in Hepatitis B Virus Detection
Published on: December 15, 2023
Testing for hepatitis B virus and HIV in patients with chronic hepatitis C: screening performance and outcome
Maria Bolther1, Lars Skov Dalgaard, Lena Hagelskjaer Kristensen
1From the Department of Infectious Diseases, Aarhus University Hospital.
Insights
Hepatitis C virus (HCV) patients often have incomplete screening for hepatitis B virus (HBV) and human immunodeficiency virus (HIV), with many remaining HBV non-immune. Proactive screening and vaccination strategies are needed for these co-infected individuals.
Area of Science:
- Hepatology
- Infectious Diseases
- Public Health
Background:
- Patients with chronic hepatitis C virus (HCV) infection are at higher risk of liver disease progression when co-infected with hepatitis B virus (HBV) and/or human immunodeficiency virus (HIV).
- Assessing screening performance for HBV and HIV in HCV patients is crucial for managing co-infections and preventing liver disease complications.
Purpose of the Study:
- To evaluate the screening performance and outcomes for HBV and HIV in patients with chronic HCV infection.
- To determine the prevalence of HBV and HIV co-infection and HBV immune status in the HCV patient cohort.
Main Methods:
- Retrospective analysis of HBV and HIV serology data from a quality assurance database (1996-2011).
- Complementary serology tests were performed for patients with incomplete or missing data to assess co-infection and immune status.
Main Results:
- Among 624 HCV patients, 2% had chronic HBV co-infection and 5% had HIV co-infection.
- Approximately 50% of patients were HBV non-immune or had unknown HBV serology status.
- HBV and HIV screening coverage at HCV diagnosis increased significantly over the 16-year study period.
Conclusions:
- Despite improvements, HBV and HIV screening in HCV patients remained incomplete.
- A substantial proportion of HCV patients were HBV non-immune or had unknown HBV serology, highlighting a need for better management.
- The study recommends a more proactive screening approach and enhanced HBV vaccination strategies for patients with chronic HCV infection.
Background:
Patients infected with hepatitis C virus (HCV) and co-infected with hepatitis B virus (HBV) and/or human immunodeficiency virus (HIV) are at increased risk for progression of liver disease. The aim of this study was to assess HBV and HIV screening performance and outcome in HCV patients followed at a Danish university hospital and affiliated regional outpatient clinics.
Methods:
HBV and HIV serology data were extracted from a quality assurance database for the assessment of screening performance in patients diagnosed with chronic HCV infection during the period 1 January 1996 to 31 December 2011. Patients with incomplete and missing serology data had complementary serology tests performed to assess the prevalence of HBV and HIV co-infection and HBV immune status.
Results:
Among 624 HCV patients, 10 (2%) were co-infected with chronic HBV and 32 (5%) with HIV. Approximately half of the cohort were non-immune to HBV or had an unknown HBV serology status. Serology results consistent with resolved infection and HBV vaccination were found in 209 (33%) and 65 (10%) patients, respectively. During the 16-y observation period, HBV and HIV screening coverage at HCV diagnosis increased from 23% to 92% and from 38% to 80%, respectively.
Conclusion:
Despite improvements throughout the study period, HBV and HIV serology screening remained incomplete. The majority of patients were either HBV non-immune or had an unknown HBV serology status. These findings thus call for a more proactive screening approach as well as an improved HBV vaccination strategy for patients with chronic HCV infection.
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