Hepatitis Outreach Network: A practical strategy for hepatitis screening with linkage to care in foreign-born communities

Journal of Hepatology
Volume 58, Issue 5 , Pages 890-897, May 2013

Ponni V. Perumalswami,  Stephanie H. Factor, Luciano Kapelusznik, Scott L. Friedman, Calvin Q. Pan, Charissa Chang, Frances Di Clemente, Douglas T. Dieterich

Division of Liver Diseases, The Mount Sinai Medical Center, Mount Sinai School of Medicine, NY, United States

Received 24 August 2012; received in revised form 26 December 2012; accepted 7 January 2013. published online 16 January 2013.

Abstract

Background & Aims

Many foreign-born persons in the US are at high risk of chronic hepatitis B (HBV) and C (HCV) infections, yet are not aware of their infection, and lack healthcare coverage or linkage to care.

Methods

A unique partnership, the Hepatitis Outreach Network, combines the expertise and resources of the Mount Sinai School of Medicine, the NYC Department of Health and Mental Hygiene, and community-based organizations, to provide education, screening and link to care in communities with high prevalence of chronic viral hepatitis. Comprehensive HBV and HCV screening identifies infected patients, who then receive further evaluation from either local or Mount Sinai physicians, combined with patient-navigators who organize follow-up visits.

Results

Of 1603 persons screened, 76 had HBV and 75 had HCV. Importantly, screening for HCV based on traditional risk factors would have missed 67% of those who tested positive. Of the 76 persons with HCV infection, 49 (64%) received a medical evaluation (26 with local providers and 23 at Mount Sinai). Of the 49 HCV-infected persons evaluated, treatment was recommended in 11 and begun in 8 (73%). Of the 76 persons with HBV infection, 43 (57%) received a medical evaluation (31 with local providers and 12 at Mount Sinai). Of the 43 HBV-infected persons evaluated, treatment was recommended and begun in 5 (100%).

Conclusions

Hepatitis Outreach Network has successfully established novel proof of concept for identifying HBV and HCV infections in foreign-born persons through use of several unique elements that effectively link them to care.

Keywords: Epidemiology, Patient navigators, Viral hepatitis, Testing, Treatment

PII: S0168-8278(13)00017-2

doi:10.1016/j.jhep.2013.01.004

© 2013 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved

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