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

Frontiers in Public Health

Public Health

Francisco Gea Rodríguez¹  Matilde Sánchez-Conde²  Javier Martínez-Sanz²  María J. Vivancos-Gallego²  María Jesús Pérez-Elías²  Alejandro G. García-Ruiz de Morales³  Santiago Moreno³  Carmen María Cano de Luque⁴  María Dolores González Vázquez⁵  Ander González-Sarria⁶  Juan Carlos Galán⁷  Beatriz Romero-Hernández⁷  Manuel Vélez-Díaz-Pallarés⁸ 

[1] Department of Gastroenterology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain;Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain;CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain;Department of Infectious Diseases, Hospital Universitario Ramón y Cajal and Instituto de Investigación Sanitaria Ramón y Cajal (IRYCIS), Madrid, Spain;Universidad de Alcalá, Alcalá de Henares, Spain;CIBER de enfermedades infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain;Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain;Department of Internal Medicine, Hospital de Braga, Braga, Portugal;Department of Microbiology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain;Department of Microbiology, Hospital Universitario Ramón y Cajal and IRYCIS, Madrid, Spain;CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain;Department of Pharmacy, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain;

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

DOI  :  10.3389/fpubh.2023.1136988

 received in 2023-01-03, accepted in 2023-06-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundMissed 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.MethodsThis 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.ResultsA 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.ConclusionA short session for non-ID physicians can improve HIV/HCV screening, increase diagnosis, and contribute to disease elimination.

【 授权许可】

Unknown   
Copyright © 2023 García-Ruiz de Morales, Martínez-Sanz, Vivancos-Gallego, Sánchez-Conde, Vélez-Díaz-Pallarés, Romero-Hernández, Vázquez, de Luque, González-Sarria, Galán, Rodríguez, Moreno and Pérez-Elías.