scholarly journals Hepatitis C screening and referral for further investigation and treatment in a tertiary care hospital

2020 ◽  
Vol 14 (06) ◽  
pp. 642-646
Author(s):  
Gülşen İskender ◽  
Duygu Mert ◽  
Sabahat Çeken ◽  
Melike Bahçecitapar ◽  
Ayla Yenigün ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Hepatitis C ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Screening Tests ◽  
Hcv Rna ◽  
Care Hospital ◽  
Electronic Reminder ◽  
Treatment Protocols ◽  
Hcv Screening

Introduction: Hepatitis C virus infection is a major cause of cirrhosis and liver cancer worldwide. The knowledge of physicians about what should they do in case of any anti-HCV positivity in screening tests is of great importance. In this study the awareness and knowledge of physicians is evaluated by analyzing the rate of the referrals of anti-HCV positive patients to HCV RNA test and their treatment by different clinics. Methodology: The patients tested for anti-HCV in internal medicine, surgery, gastroenterology and infectious disease clinics between 1 January and 31 December 2017 were evaluated retrospectively in a tertiary care hospital. Results: Anti-HCV testing was performed in 32,803 patients. Anti-HCV positivity was detected in 95 (0.28%) patients aged 88 years of age or younger (mean 60.89 ± 16.96 years), 57.89% of them were female. HCV RNA was tested in 50 (%52,63) of anti-HCV positive patients and it was found positive in 18 (36%) patients. In anti-HCV positive patients HCV RNA testing was requested most by infectious disease (100%) and gastroenterology (70.58%) clinics and least by surgery and other clinics (21% and 25% respectively). These differences were found to be statistically significant ( =33.65, p < 001). Conclusions: Our study highlights the significant deficiencies existed in the referring patients with anti-HCV positivity for further examination and treatment by the attending physicians especially in surgical clinics. Performing HCV screening in the different steps of medical care and using electronic reminder systems directing physicians at appropriate diagnostic and treatment protocols can maximize the likelihood of the detection and treatment of HCV- infected patients.

CLINICAL PROFILE AND THE CIRCULATING GENOTYPES OF HEPATITIS C VIRUS IN A TERTIARY CARE HOSPITAL IN WEST BENGAL

2021 ◽  
pp. 165-167
Author(s):  
Kumkum Sarkar ◽  
Rupak Chatterjee ◽  
Sumanta Sinha ◽  
Netai Pramanik
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hcv Rna ◽  
Care Hospital ◽  
Patient Department

Background and objectives- Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide, with majority of the patients being asymptomatic and when they present to clinicians, they have already advanced liver disease in form of cirrhosis or hepatocellular carcinoma. Data from developing countries on this evolving global health problem are sparse. Hence this study was planned with the aim to determine the HCV genotypes prevalant in patients attending a tertiary care hospital with their clinical prole. Materials and Methods- Detailed history taking and clinical examination were done of consecutive 30 patients who attended out-patient department or admitted at in- patient department of Tropical Medicine with chronic hepatitis C. Laboratory investigations like LFT, viral serology (HBsAg, AntiHCV, HIV), prothrombin time, ultrasonography of upper abdomen, HCV- RNA Quantative assay with genotyping were done. Data were collected and then analysed using standard statistical methods. Result- Of proposed 30 sample size, complete data could be collected of 28 patients and accordingly, analysis was done. Of the 28 HCV seroreactive individuals, majority (20) were males. The mode of transmission was unknown in 19 patients, blood transfusion in 5 patients who were thalassemic and hemodialysis in remaining 4 patients. Most of the patients (18/28) were asymptomatic even if their viral load was high. Most common presenting symptom was dyspepsia. LFT showed signicant transaminitis in 50% of the patients. Of the 28 seroreactive patients, 15 (53.57%) were HCV RNA positive based on RT-PCR. HCV rNA was below detectable level in 13 patients. HCV genotype 3 was the predominant genotype found in 11 individuals followed by genotype 1 found in 3 and genotype 2 was seen in one individual. Conclusion- Community screening specially among high risk individuals is needed for early diagnosis and prompt treatment of chronic hepatitis C to prevent its several complications and also to prevent community spread.

scholarly journals Effectiveness of Sofosbuvir and Daclatasvir in treatment of Hepatitis-C: An experience of tertiary care hospital in Karachi

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Nazish Butt ◽  
Anoshia Saleem ◽  
Muhammad Ali Khan ◽  
Ali Akbar
Keyword(s):  
Hepatitis C ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Decompensated Cirrhosis ◽  
Secondary Outcome ◽  
Hcv Rna ◽  
Care Hospital ◽  
Creative Commons ◽  
Compensated Cirrhosis ◽  
Treatment Naïve

Objective: To assess the effectiveness of Sofosbuvir (SOF) and Daclatasvir (DCV) in patients with chronic hepatitis C (CHC), compensated cirrhosis (CC) and decompensated cirrhosis (DCLD) either treatment naïve or experienced. Methods: This was a prospective, observational study, conducted from January 2017 to December 2018 at Jinnah Postgraduate Medical Centre, Karachi. All patients above 12 years of age with detectable HCV RNA PCR were included. Patients were divided into three groups: CHC, CC and DCLD. SOF and DCV for 12 or 24 weeks were given. Ribavirin (RBV) was given to treatment experienced and cirrhotic patients. Primary outcome was End of Treatment Response (ETR) and secondary outcome was Sustained Virological Response (SVR) at post treatment week 12 or 24. Results: Total 300 patients with mean age of 40.49 ± 13.86 were enrolled. Majority were females 174 (58%). CHC were 200 (66.6%) while cirrhotic were 100 (33.4%). Treatment naïve patients were 267 (89%) and 33 (11%) patients were experienced. Most common genotype was 3 (83%). ETR was achieved in 292 (97.33%) and SVR in 265 (88.33%) patients respectively. Conclusion: SOF plus DCV with or without RBV is a highly effective treatment for chronic HCV and is still used in many centers of Pakistan. This regimen has excellent results for GT-3. The outcomes are mainly influenced by the presence or absence of cirrhosis. doi: https://doi.org/10.12669/pjms.37.7.4627 How to cite this:Butt N, Anoshia, Khan MA, Akbar A. Effectiveness of Sofosbuvir and Daclatasvir in treatment of Hepatitis-C: An experience of tertiary care hospital in Karachi. Pak J Med Sci. 2021;37(7):2014-2019. doi: https://doi.org/10.12669/pjms.37.7.4627 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Strategy for the Micro-Elimination of Hepatitis C among Patients with Diabetes Mellitus—A Hospital-Based Experience

2021 ◽  
Vol 10 (11) ◽  
pp. 2509
Author(s):  
Pei-Yuan Su ◽  
Yang-Yuan Chen ◽  
Hsu-Heng Yen ◽  
Siou-Ping Huang ◽  
I-Ling Liu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Electronic Reminder ◽  
Reminder System ◽  
Induce Insulin Resistance ◽  
Patients With Diabetes ◽  
Hcv Antibody ◽  
Hcv Screening

Hepatitis C virus (HCV) infection can induce insulin resistance, and patients with diabetes mellitus (DM) have a higher prevalence of HCV infection. Patient outcomes improve after HCV eradication in DM patients. However, HCV micro-elimination targeting this population has not been approached. Little is known about using electronic alert systems for HCV screening among patients with DM in a hospital-based setting. We implemented an electronic reminder system for HCV antibody screening and RNA testing in outpatient departments among patients with DM. The screening rates and treatment rates at different departments before and after system implementation were compared. The results indicated that the total HCV screening rate increased from 49.3% (9505/19,272) to 78.2% (15,073/19,272), and the HCV-RNA testing rate increased from 73.4% to 94.2%. The anti-HCV antibody seropositive rate was 5.7%, and the HCV viremia rate was 62.7% in our patient population. The rate of positive anti-HCV antibodies and HCV viremia increased with patient age. This study demonstrates the feasibility and usefulness of an electronic alert system for HCV screening and treatment among DM patients in a hospital-based setting.

scholarly journals Detection and distribution of genotypes of Hepatitis C in a tertiary care hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 5249
Author(s):  
Upasana Bhumbla ◽  
Laveena Shekhawat ◽  
Aditi Kothari ◽  
Jatin Rao
Keyword(s):  
Hepatitis C ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals 932. Universal Hepatitis C Virus Screening in a Tennessee Tertiary Care Emergency Department

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S31-S32 ◽  
Author(s):  
Cody A Chastain ◽  
Jakea Johnson ◽  
Karen Miller ◽  
Katie Moore ◽  
Amanda Lako ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Tertiary Care ◽  
Linkage To Care ◽  
Hcv Rna ◽  
Grant Recipient ◽  
Age Cohort ◽  
Hcv Antibody ◽  
Hcv Screening

Abstract Background Despite hepatitis C virus (HCV) age cohort and risk factor screening recommendations, many at-risk individuals remain undiagnosed. Current screening practices may not adequately capture those at high risk for infection, especially in regions with increasing injection drug use (IDU). Universal HCV screening in a Tennessee tertiary care emergency department (ED) was introduced to help define regional epidemiology and to improve diagnosis and linkage to care. Methods This screening program was implemented in the Vanderbilt University Medical Center ED. Adult patients who underwent phlebotomy for clinical purposes were offered HCV screening. Samples were initially tested for HCV antibodies; if positive, samples were reflexed for HCV RNA testing. Patients with positive HCV RNA tests (i.e., active HCV infection) were notified, counseled, and offered linkage to care. Results A total of 11,637 screening tests were performed between April 1, 2017 and March 31, 2018, with 1,008 (8.7%) HCV antibody positive and 488 (4.2%) RNA positive. Of note, 81 (0.7%) were HCV antibody positive but RNA testing could not be performed due to insufficient sample volume. Several notable populations had high rates of HCV (Table 1). Importantly, 3.9% of people not born between 1945 and 1965 were HCV RNA positive, and they were the majority (63.5%) of patients with active HCV (Table 2). A minority (31.6%) of those with active HCV had a known history of IDU (Table 2). Conclusion HCV is common among patients presenting for emergency care at a Tennessee tertiary care ED. Universal screening identified many infections that would have been missed using age cohort and risk factors alone. ED HCV screening may be a useful method to augment guideline-based testing and intervene among populations not consistently screened. Disclosures C. A. Chastain, Gilead Sciences, Inc.: Grant Investigator and Research Contractor, Grant recipient and Research support. J. Johnson, Gilead Sciences, Inc.: Grant Investigator, Grant recipient. K. Miller, Gilead Sciences, Inc.: Grant Investigator, Grant recipient. J. H. Han, Gilead Sciences, Inc.: Grant Investigator, Grant recipient. W. H. Self, Gilead Sciences, Inc.: Grant Investigator, Grant recipient.

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