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Canadian Journal of Gastroenterology and Hepatology
Volume 28, Issue 6, Pages 315-318
http://dx.doi.org/10.1155/2014/190210
Original Article

Screening, Detecting and Enhancing the Yield of Previously Undiagnosed Hepatitis B and C In Patients with Acute Medical Admissions to Hospital: A Pilot Project Undertaken at the Vancouver General Hospital

Jordanna E Kapeluto,1 Matthew Kadatz,1 Andrew Wormsbecker,1 Kiran Sidhu,1 and Eric M Yoshida2

1Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
2Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada

Received 31 August 2013; Accepted 28 April 2014

Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) represent an increasing health burden and morbidity in Canada. Viral hepatitis, specifically HCV, has high prevalence among persons born between 1945 and 1965, with 45% to 85% of infected adults asymptomatic and unaware of their infection. Screening has been shown to be cost effective in the detection and treatment of viral hepatitis.

OBJECTIVE: To quantify incidence and identify undocumented HBV and HCV infection in hospitalized patients at a single centre with secondary analysis of risk factors as part of a quality improvement initiative.

METHODS: A one-time antibody test was conducted in patients admitted to the acute medicine and gastroenterology services.

RESULTS: Over a 12-week period, hospital screening for HBV and HCV was performed in 37.3% of 995 admitted patients. There was identification of 15 previously undiagnosed cases of HCV (4%) and 36 undocumented cases of occult (ie, antihepatitis B core antigen seropositive) or active (ie, hepatitis B surface antigen seropositive) HBV (9.7%). Among patients with positive screens, 60% of seropositive HCV patients had no identifiable risk factors.

CONCLUSIONS: The prevalence of HBV and HCV infection among hospitalized patients in Vancouver was higher than that of the general population. Risk factors for contraction are often not identified. These results can be used as part of an ongoing discussion regarding a ‘seek and treat’ approach to the detection and treatment of chronic blood-borne viral illnesses.