Testing and linkage to care for viral hepatitis in patients admitted for psychiatric care.

Author: Sandra Dröse, Lisbeth Skovmand, Zoltan Barkanyi, Dorte Kinggaard Holm Holm, Peer Brehm Christensen, Anne Holm Lindebo Øvrehus

Theme: Clinical Research Year: 2023

The estimated hepatitis C virus (HCV) prevalence is 0.21 % and for hepatitis B virus (HBV) the prevalence is 0.3% in Denmark. The proportion of undiagnosed HCV patients is 24 % and for HBV 7%.  Screening of psychiatric patients in care could be a possible opportunity to find undiagnosed patients, which has been shown in other countries.  Aim of the study is to find the prevalence of HBV and HCV infection among patients admitted to a psychiatric ward.

Patients admitted to psychiatric short or long term care between 4/11/2022 to 1/06/23 at Odense University Hospital will be screened for HBV (HBsAg, anti-HBc and anti-HBs) and HCV (anti-HCV with HCV-RNA reflex testing) infection as a pilot for the feasibility for this approach in standard of care.
If patients test positive for either HBsAg or HCV-RNA further blood investigations (genotype, liver transaminases, HIV status) will be performed during hospitalization. Patients will be linked to care at the Department of Infectious Diseases and treatment initiated during their admission in psychiatry.

300 consecutive persons admitted, were tested in the period November 4th, 2022 until March 16th, 2023. Two patients (0.67%) were positive HBsAg. None of them were aware of their infection. Both were linked to care during hospitalization without need for treatment initiation. Three patients (1%) had a positive HCV RNA of which one was known. One patient had an acute HCV infection with a spontaneous rapid decline in HCV-RNA and he was discharged without treatment for outpatient follow-up. One patient started treatment during hospitalization and one was discharged before the results were available and currently lost to follow up.

Screening for viral hepatitis as standard of care among patients admitted to a psychiatric ward is a good opportunity to find the undiagnosed and link them to care.

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