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. 2023 Jun 26:11:1136988.
doi: 10.3389/fpubh.2023.1136988. eCollection 2023.

HIV and HCV screening by non-infectious diseases physicians: can we improve testing and hidden infection rates?

Alejandro G García-Ruiz de Morales  1   2   3 , Javier Martínez-Sanz  1   3 , María J Vivancos-Gallego  1   3 , Matilde Sánchez-Conde  1   3 , Manuel Vélez-Díaz-Pallarés  4 , Beatriz Romero-Hernández  5   6 , María Dolores González Vázquez  7 , Carmen María Cano de Luque  8 , Ander González-Sarria  9 , Juan Carlos Galán  5   6 , Francisco Gea Rodríguez  10 , Santiago Moreno  1   2   3 , María Jesús Pérez-Elías  1   3
Affiliations

HIV and HCV screening by non-infectious diseases physicians: can we improve testing and hidden infection rates?

Alejandro G García-Ruiz de Morales et al. Front Public Health. .

Abstract

Background: Missed opportunities for Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) testing remain high. We aimed to ascertain the knowledge of screening guidelines and attitudes of non-infectious disease (ID) hospital physicians and assess the impact of a 1-h session on screening rates and diagnoses.

Methods: This interventional study consisted of a 1-h training session on HIV and HCV epidemiology and testing guidelines for non-ID physicians. Pre-and post-session questionnaires compared the knowledge of the guidelines and attitudes toward screening before and after the session. Rates of screening and diagnoses were compared in three 6 months periods: before, immediately after, and 24 months ±4 after the session.

Results: A total of 345 physicians from 31 departments participated in these sessions. Before the session, 19.9% (28% medical, 8% surgical) and 17.9% (30% medical, 2.7% surgical) were aware of HIV and HCV testing guidelines, respectively. The willingness to routinely test increased from 5.6 to 22%, whereas not ordering tests decreased from 34.1 to 2.4%. HIV screening rates significantly increased by 20% after the session (7.7 vs. 9.3 tests per 103 patients; p < 0.001), and the effect persisted until the long-term period. The HIV diagnosis rate increased globally (3.6 vs. 5.2 HIV diagnoses per 105 patients; p = 0.157), mainly because of medical services (4.7 vs. 7.7 per 105 patients; p = 0.082). The HCV screening rate increased significantly immediately and in the long term only in medical services (15.7 and 13.6%, respectively). The new active HCV infection rates increased immediately and declined steeply thereafter.

Conclusion: A short session for non-ID physicians can improve HIV/HCV screening, increase diagnosis, and contribute to disease elimination.

Keywords: HCV testing; HIV testing; diagnostic screening programs; formative session; hospital intervention; late diagnosis; missed opportunities; screening.

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Conflict of interest statement

AG-R reports personal fees for educational events and non-financial support, including support for attending meetings and/or travel from ViiV Healthcare, Gilead Sciences, Merck Sharp & Dohme and Abbvie, outside the submitted work. JM-S reports personal fees for presentations or educational events and non-financial support, including support for attending meetings and/or travel, from ViiV Healthcare, Janssen Cilag, Gilead Sciences, Merck Sharp & Dohme and Abbvie outside the submitted work. MV-G has received honoraria (grants and personal fees) as a speaker in educational programs sponsored by ViiV, and Gilead; and has received support (registration, travel assistance) for expert courses and congresses by MSD and ViiV. BR-H has received funding to attend conferences from Gilead Sciences and obtained a financed project from Roche. SM has been involved in speaking activities and received grants for research from Gilead Sciences, Janssen Cilag, Merck, Sharp & Dohme and ViiV Healthcare. MP-E has received funding to attend conferences, educational activities or advisory, as well as scholarships from the pharmaceutical companies Gilead Sciences, Janssen, Abbvie, MSD, and ViiV. JG has received funding to attend conferences, educational activities or advisory, from the pharmaceutical companies Gilead Sciences, Abbvie, Abbott, MSD and Roche. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Evolution of the global screening rate and active infection globally, in medical and surgical departments. The figure shows the evolution of the rate of screening (A,C) and active infection (B,D) for HIV (A,B) and HCV (C,D) in the pre-, post-session and long-term periods. Each sub-figure has a representation of the global rates broken down by medical and surgical departments. * Active HCV infection is defined as a positive HCV antigen.
See this image and copyright information in PMC

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