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. 2019 Apr 16;16(1):47.
doi: 10.1186/s12985-019-1157-1.

Hepatitis C screening in hospitals: find the missing patients

Lili Liu  1 , Hongqin Xu  1 , Yue Hu  2 , Jia Shang  3 , Jianning Jiang  4 , Lei Yu  5 , Caiyan Zhao  6 , Dazhi Zhang  7 , Xinxin Zhang  8 , Junfeng Li  9 , Wei Li  3 , Yanan Wu  3 , Diefei Hu  4 , Xiaofang Wang  10 , Qian Zhao  6 , Qiongfang Zhang  7 , Wenqiang Luo  7 , Jia Chen  8 , Donghua Zhang  8 , Wei Zhou  9 , Junqi Niu  11
Affiliations

Hepatitis C screening in hospitals: find the missing patients

Lili Liu et al. Virol J. .

Abstract

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver cancer, creating enormous economic and social burdens. The Chinese government recommends routine screening of inpatients for HCV before invasive procedures to prevent iatric infections. However, the diagnosis and treatment rates for HCV remain low. The aim of this study was to use available routine screening data to understand the HCV screening of inpatients in different regions of China.

Methods: Inpatient information and HCV screening results were collected from January 2016 to December 2016 at eight tertiary hospitals in different regions of China to compare the HCV-positivity of hospitalized patients among different regions and age groups.

Results: The HCV screening rate of inpatients was more than 50%. A total of 467,008 inpatients were enrolled in the study (51.20% were male), and the HCV antibody (anti-HCV) -positive rate was 0.88% (95% confidence interval [CI], 0.85-0.91%) among the total population. This rate was significantly higher among all males compared with all females (0.91% vs 0.85%). Moreover, the HCV antibody-positive rate increased with age and was highest for the 60-64-year age group. Notably, 90.14% (3722/4129) of the anti-HCV seropositive patients were 40 years of age or older. HCV screening for people over 40 years old is recommended.

Conclusions: This study highlights the key role of routine examination for HCV infection in hospitalized patients. Full use of inpatient screening results to manage HCV antibody-positive patients and a screening strategy targeting inpatients 40 years and older were found to be low-cost and effective, which will help to find the missing millions of yet unaware patients and also accelerate the elimination of HCV in China.

Keywords: Hepatitis C virus; Hospital; Positive rate; Screening.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Ethics Committee of the Frist Hospital of Jilin University (No.2017–379).

Consent for publication

All authors approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Data selection process
Fig. 2
Fig. 2
Distribution of participating hospitals across China. The provinces in which the participating hospitals are located are shaded, and the number of patients included in each hospital is shown with the corresponding percentage among the total study population. Asterisks denote the three hospitals with the largest numbers of included patients
Fig. 3
Fig. 3
Comparison of HCV antibody-positive rates between males and females in different age groups. The overall anti-HCV antibody-positive rate in males and females are shown on the left. The HCV antibody-positive rates were less than 0.2% in all groups from 0 to 19 years of age, and the HCV antibody-positive rates were higher in men than in women in all age groups from 20 to 44 years (denoted by the dotted line)
Fig. 4
Fig. 4
HCV antibody-positive rates in different regions according to age. The hospitals represented by the four graphs on top are located in four cities in the northern part of China, and those represented by the four graphs on bottom are located in four cities in the central, eastern, and southern parts of China
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