Towards the elimination of hepatitis Cimplementation of reflex testing in Andalusia

  1. María de la Paz Casas Hidalgo 1
  2. Luis Fernando García Contreras 1
  3. Carolina Freyre Carrillo 2
  4. Natalia Montiel Quezel-Guerraz 3
  5. Alberto de la Iglesia Salgado 4
  6. Mª Isabel Viciana 5
  7. Ana Domínguez Castaño 6
  8. Vicente Guillot 7
  9. Aurora Muñoz Colmenero 8
  10. Purificación Cantudo 9
  1. 1 Hospital Universitario San Cecilio. Instituto de Investigación Ibs. Granada, Spain
  2. 2 Hospital Universitario Puerto Real. Puerto Real, Cádiz. Spain
  3. 3 Hospital Costa del Sol. Marbella, Málaga. Spain
  4. 4 Hospital Infanta Elena. Huelva, Spain
  5. 5 Hospital Universitario Virgen de la Victoria. Málaga, Spain
  6. 6 Hospital Universitario Juan Ramón Jiménez. Huelva, Spain
  7. 7 Hospital Ciudad de Jaén. Jaén, Spain
  8. 8 Hospital San Juan de la Cruz. Úbeda, Jaén. Spain
  9. 9 Hospital San Agustín. Linares, Jaén. Spain
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Revista:
Revista Española de Enfermedades Digestivas

ISSN: 2340-416,  1130-0108

Año de publicación: 2020

Volumen: 112

Número: 7

Páginas: 515-519

Tipo: Artículo

DOI: 10.17235/REED.2020.6370/2019 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Revista Española de Enfermedades Digestivas

Resumen

Background and aim: undiagnosed hepatitis C virus (HCV) infection and/or inadequate access to care are barriers to the elimination of HCV. Reflex testing has proven to facilitate referral to care, treatment and viral elimination. In this study, a reflex testing program was implemented in Andalusia and its impact on access to care was evaluated. Patients and methods: an observational, retrospective and prospective study was performed across diagnostic laboratories responsible for HCV diagnosis in southern Spain. After surveying the barriers to performing reflex testing, the number of patients that were not referred for care in 2016 was retrospectively studied (pre-reflex cohort). Subsequently, several measures were proposed to overcome the identified barriers. Finally, reflex testing was implemented and its impact evaluated. Results: the pre-reflex cohort included information from 1,053 patients. Slightly more than half of the patients (n = 580; 55%) visited a specialist for treatment evaluation during a median period of 71 days (interquartile range = 35-134) since the date of diagnosis. The post-reflex cohort (September 2017 to March 2018) included 623 patients. Only 17% (n = 106) of the patients had not been referred for care or evaluated for treatment in a median period of 52 days (interquartile range = 28-86). Conclusions: in 2016, nearly half of new HCV diagnoses in southern Spain were not referred for care. Barriers to the implementation of reflex testing were overcome in our study. Moreover, this strategy was effectively implemented in 2017. Reflex testing contributed to improving referral for care. This program will contribute to the micro-elimination of hepatitis C in Spain.

Fuente de los datos: Dialnet