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Assessing testing rates for viral hepatitis B and C by general practitioners in Flanders, Belgium: a registry-based

Rob Bielen1,2, Özgür M Koc1,2,3, Dana Busschots1,2

  • 1Faculty of Medicine and Life Sciences, Universiteit Hasselt, Hasselt, Belgium.

BMJ Open
|May 11, 2019
PubMed

Insights

Hepatitis B (HBV) and C (HCV) testing by general practitioners in Flanders, Belgium, is low, even for patients with liver enzyme elevation. Increased testing is crucial for diagnosis and care.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections significantly contribute to global mortality.
  • Despite available effective treatments for HBV and HCV, diagnosis rates remain low, particularly in Belgium (<50%).
  • General practitioners (GPs) are pivotal in the prevention, diagnosis, and management of viral hepatitis.

Purpose of the Study:

  • To evaluate the real-world testing and diagnosis rates for HBV and HCV by GPs in Flanders, Belgium.
  • To assess HBV and HCV screening prevalence within primary care settings.

Main Methods:

  • A retrospective analysis of electronic medical records from 48 primary care practices in Flanders, Belgium.
  • Data from a central registry encompassing 440,140 patients over 20 years, representing 2.2% of the Flemish population annually.
  • Analysis of testing rates for hepatitis B surface antigen (HBsAg) and hepatitis C antibody (HCV Ab), including patients with chronically elevated liver enzymes.

Main Results:

  • Overall screening rates were low: 1.8% for HBsAg and 1.6% for HCV Ab among 440,140 patients.
  • In patients with chronic liver enzyme elevation, testing rates were higher but still suboptimal: 7.9% for HBsAg and 9.9% for HCV Ab.
  • No significant improvement in testing rates was observed over the 20-year study period.

Conclusions:

  • Real-world testing uptake for viral hepatitis B and C in Flemish general practices is suboptimal.
  • Testing rates remain low even in patient groups with indicators of liver disease, such as chronically elevated liver enzymes.
  • Urgent implementation of strategies to enhance HBV and HCV testing uptake by GPs is necessary to improve diagnosis and patient care.
Abstract

Keywords:
general practitionerstesting policyviral hepatitis

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