July 6, 2011

Universal screening for hepatitis C supported by patients

Posted on HemOncToday.com July 6, 2011

Coffin PO. BMC Infect Dis. 2011;doi:10.1186/1471-2334-11-160.
Patients with hepatitis C support universal screening for the disease, even if the testing is conducted without patient consent, according to researchers from the University of Washington in Seattle.

In the United States, there are 2.9 million to 3.7 million people with hepatitis C, and approximately 70% of them are unaware of their infection. Universal screening may help reduce this number; however, there have been few efforts to determine patients’ opinions on the topic.

“National guidelines recommend that testing for hepatitis C virus be limited to persons with identified risk factors, such as injection drug use, a blood transfusion prior to 1992, or elevated liver function tests,” the researchers wrote. “Although these recommendations are based on epidemiologic data and 1998 CDC guidelines, barriers to risk-based screening have resulted in inadequate detection of hepatitis C virus.”

The researchers conducted an anonymous, self-administered, cross-sectional survey of 233 outpatients at Harborview Medical Center in Seattle. They asked participants to define the importance of testing for hepatitis C virus compared with HIV and diabetes mellitus. Two hundred patients completed the survey.

Most patients (76%) said the hospital should test all of its patients for hepatitis C virus. In addition, 73.2% said the hospital should test all of its patients for HIV, and 68.3% said the hospital should test all of its patients for diabetes. Most patients, however, said it would not be OK for the hospital to automatically test for hepatitis C and HIV without telling the patient. In addition, 75.3% of patients said it is better to be tested without knowing about it than to not be tested at all. Universal testing without being informed of being tested or provided with negative results was preferred by 48% of the patients, whereas 37% preferred the chance to opt out of testing.

“We do not believe that these findings should immediately prompt health care providers or organizations to abandon efforts to inform patients and seek consent for testing,” the researchers wrote. “However, efforts to broadly screen populations for communicable diseases have met formidable barriers.”


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