Article Figures & Data
Figures
- Figure 1
The laboratory testing algorithm used for identifying hepatitis C virus and hepatitis B virus infection.
HBV = hepatitis B virus, HBc = hepatitis B core; HBs = hepatitis B surface; HCV = hepatitis C virus; RNA = ribonucleic acid.
- Figure 2
Flow diagram of the birth cohort testing for hepatitis C virus and hepatitis B virus infection.
ALT = alanine aminotransferase; DNA = deoxyribonucleic acid; HAV = hepatitis A virus; HBV = hepatitis B virus, HCV = hepatitis C virus.
a Medical treatment is not indicated in active HBV infections. In chronic HBV infections, treatment is indicated if the HBV DNA level is >1.0 x 105 copies/mL combined with an elevated ALT level or major liver fibrosis.
Tables
- Table 1
Sociodemographic Determinants of Test Uptake of the Public Health and Primary Care Birth Cohort Testing Strategy
Determinant Test Uptake % (No.) Not Tested % (No.) OR (95% CI)a Higher prevalence area Hotspot A (n=2,891) 50.2 (1,450) 49.8 (1,441) 1.05 (0.95–1.16) Hotspot B (n=3,949) 50.2 (1,984) 49.8 (1,965) 1 [Reference] Sex Male (n=3,417) 46.0 (1,571) 54.0 (1,846) 1 [Reference]b Female (n=3,423) 54.4 (1,863) 45.6 (1,560) 1.41 (1.28–1.55) Age, y 40–49c (n=1,891) 35.0 (662) 65.0 (1,229) 1 [Reference]b 50–59 (n=2,531) 51.0 (1,292) 49.0 (1,239) 1.93 (1.71–2.18) 60–70d (n=2,418) 61.2 (1,480) 38.8 (938) 2.95 (2.60–3.34)
Supplemental Appendix
Supplemental Appendix
Files in this Data Supplement:
- Supplemental data: Appendix - PDF file
The Article in Brief
Detecting Hepatitis B and C by Combined Public Health and Primary Care Birth Cohort Testing
Jeanne Heil , and colleagues
Background Chronic hepatitis C and B virus infections do not usually have symptoms, so many infections remain undetected or are diagnosed at a late stage. In order to detect this hidden population, researchers set out to determine the diagnostic yield (test uptake and positivity rate) of a birth cohort testing strategy in identifyting hepatitis B and C viruses.
What This Study Found A strategy to test the general population for hepatitis B and C viruses in areas of high prevalence had high test uptake but did not detect hidden chronic hepatitis C infections. The study, a public health-primary care collaboration, sought to test individuals between 40 and 70 years of age (n = 6,743) in two Dutch hepatitis hotspots. All family physicians in the hotspots invited their patients to be tested, with implementation and follow-up by the regional public health service. Test uptake was higher than expected at 51 percent (n = 3,434), however no active/chronic hepatitis C infections were detected.
Implications
- This strategy, the authors surmise, could be effective in countries with higher rates of hepatitis or other infectious diseases, but is not recommended for low prevalence countries.
