Hepatitis C virus detection in hospital emergency departments
Jordi Llaneras1, Sabela Lens2, Beatriz Valle3, Inmaculada Fernández4, Juan Macías5, Raquel Domínguez-Hernández6, Alberto De la Cuadra-Grande6, José Luis Calleja7, Federico García8, Juan González del Castillo9
Affiliation of the authors
1Servicio de Urgencias, Hospital Universitari Vall d’Hebron, Barcelona, Spain. 2Servicio de Hepatología, Hospital Clínic, FCRB/IDIBAPS, Barcelona. Universidad de Barcelona. CIBERehd, Spain. 3Servicio de Urgencias Generales, Hospital Severo Ochoa, Leganés, Madrid, Spain. 4Servicio de Aparato Digestivo, Hospital Universitario 12 de Octubre, Madrid, Spain. 5Departamento de Medicina, IBiS. Universidad de Sevilla, Hospital Universitario Virgen de Valme, CIBERINFEC, Spain. 6Pharmacoeconomics & Outcomes Research Iberia (PORIB), Madrid, Spain. 7Gastroenterología y Hepatología, IDIPHIM, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. 8Servicio de Microbiología, Hospital Universitario Clínico San Cecilio, Granada. Instituto de Investigación Ibs. Granada. Ciber de Enfermedades Infecciosas Ciberinfec, Spain. 9Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, Spain.
Llaneras J, Lens S, Valle B, Fernández I, Macías J, Domínguez-Hernández R, et al. Hepatitis C virus detection in hospital emergency departments. Emergencias. 2024;36:375-84
Summary
The prevalence of active hepatitis C virus (HCV) infection is higher in hospital emergency departments (EDs) than in the general population. Numerous patients who seek emergency care are unaware that they have detectable viremia, yet they fall outside established ED protocols for HCV screening. Often they belong to groups with difficult access to health care who use the ED as their point of entry to the system. The aim of this consensus paper was to develop an approach to guide ED detection of HCV infection in all Spanish hospitals. Experts from the Spanish Society of Emergency Medicine (SEMES), the Spanish Association for Study of the Liver (AEEH), and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) met to establish criteria to guide health care professionals’ decisions. The experts’ review of the literature and discussion in consensus-building meetings resulted in evidence-based recommendations that consider the following aspects: 1) the population to target for HCV screening in the ED, 2) how to inform patients of the process, 3) how to carry out HCV screening, 4) how to order an HCV test, and 5) additional issues such as bundling HCV with other viral tests for comprehensive diagnosis, recording results in medical records, and implementing ways to retain and follow all patients with positive results. This consensus report provides guidelines and tools to facilitate emergency physicians’ work and ensure effective detection of HCV infections and subsequent incorporation of patients into the health care system.
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