{"title":"伦敦性健康服务用户的乙肝和丙肝检测结果:伦敦居民在线性传播感染检测服务。","authors":"Sara Louise Day, Gemma McDonald, Chris Kellett","doi":"10.1136/sextrans-2023-055916","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The UK signed up to the 2016 global health strategy to eliminate viral hepatitis as a public health problem. Effective monitoring of hepatitis testing outcomes is required to track progress against targets. National reporting does not include hepatitis B and hepatitis C infections (HBV/HCV) detected by online sexually transmitted infection (STI) testing services (e-services). We identify HBV/HCV infection rates among individuals using Sexual Health London (SHL), a large e-service.</p><p><strong>Methods: </strong>SHL e-records of individuals receiving reactive HBsAg and/or HepCAb screening results between 1 January 2021 and 1 January 2022 were reviewed. Only at-risk groups are offered HBV/HCV testing, with risks captured via an online triage/consultation. Roche Cobas e801 HBV/HCV screening assay uses a cut-off index of reactivity (COI) to categorise results: low reactive (COI >1-9) and reactive (COI ≥10). SHL refers individuals with any reactive result for confirmatory testing (CT) at a sexual health clinic that provides hepatitis outpatient management. Clinic staff performing the CT access the shared SHL e-record and electronically take over the patient's care.</p><p><strong>Results: </strong>67, 718 HBV and 61 064 HCV tests were performed, representing 16% of all kit returns. HBV reactivity was 1.4% (922/67 718): 474 low-reactive, 302 reactive and 146 unconfirmed-reactive. HCV reactivity was 0.3% (163/61 064): 53 low-reactive, 99 reactive and 11 unconfirmed-reactive.Among individuals with reactive (COI ≥10) screening HBV results, 85% results confirmed, 12% negative and 3% unknown. For HCV, 79% results confirmed, 13% negative and 8% unknown. 57 out of 57 new HBV/HCV infections were electronically transferred. HBV prevalence was 299/67 718 (0.4%). The rate of previously undiagnosed cases detected was 40 out of 67 338 (0.06%) for HBV and 17 out of 61 016 (0.03%) for HCV.</p><p><strong>Conclusions: </strong>16% of SHL service users received targeted testing for hepatitis in 2021. Testing volumes significantly exceeded and new HBV/HCV diagnosis rates were similar to those reported by sentinel laboratory surveillance. 100% new infections transitioned to care, demonstrating effective integration between online and local sexual health services.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hepatitis B and hepatitis C testing outcomes among service users of Sexual Health London: an online sexually transmitted infection testing service for London residents.\",\"authors\":\"Sara Louise Day, Gemma McDonald, Chris Kellett\",\"doi\":\"10.1136/sextrans-2023-055916\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The UK signed up to the 2016 global health strategy to eliminate viral hepatitis as a public health problem. Effective monitoring of hepatitis testing outcomes is required to track progress against targets. National reporting does not include hepatitis B and hepatitis C infections (HBV/HCV) detected by online sexually transmitted infection (STI) testing services (e-services). We identify HBV/HCV infection rates among individuals using Sexual Health London (SHL), a large e-service.</p><p><strong>Methods: </strong>SHL e-records of individuals receiving reactive HBsAg and/or HepCAb screening results between 1 January 2021 and 1 January 2022 were reviewed. Only at-risk groups are offered HBV/HCV testing, with risks captured via an online triage/consultation. Roche Cobas e801 HBV/HCV screening assay uses a cut-off index of reactivity (COI) to categorise results: low reactive (COI >1-9) and reactive (COI ≥10). SHL refers individuals with any reactive result for confirmatory testing (CT) at a sexual health clinic that provides hepatitis outpatient management. Clinic staff performing the CT access the shared SHL e-record and electronically take over the patient's care.</p><p><strong>Results: </strong>67, 718 HBV and 61 064 HCV tests were performed, representing 16% of all kit returns. HBV reactivity was 1.4% (922/67 718): 474 low-reactive, 302 reactive and 146 unconfirmed-reactive. HCV reactivity was 0.3% (163/61 064): 53 low-reactive, 99 reactive and 11 unconfirmed-reactive.Among individuals with reactive (COI ≥10) screening HBV results, 85% results confirmed, 12% negative and 3% unknown. For HCV, 79% results confirmed, 13% negative and 8% unknown. 57 out of 57 new HBV/HCV infections were electronically transferred. HBV prevalence was 299/67 718 (0.4%). The rate of previously undiagnosed cases detected was 40 out of 67 338 (0.06%) for HBV and 17 out of 61 016 (0.03%) for HCV.</p><p><strong>Conclusions: </strong>16% of SHL service users received targeted testing for hepatitis in 2021. Testing volumes significantly exceeded and new HBV/HCV diagnosis rates were similar to those reported by sentinel laboratory surveillance. 100% new infections transitioned to care, demonstrating effective integration between online and local sexual health services.</p>\",\"PeriodicalId\":21624,\"journal\":{\"name\":\"Sexually Transmitted Infections\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-07-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sexually Transmitted Infections\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/sextrans-2023-055916\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexually Transmitted Infections","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/sextrans-2023-055916","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Hepatitis B and hepatitis C testing outcomes among service users of Sexual Health London: an online sexually transmitted infection testing service for London residents.
Objectives: The UK signed up to the 2016 global health strategy to eliminate viral hepatitis as a public health problem. Effective monitoring of hepatitis testing outcomes is required to track progress against targets. National reporting does not include hepatitis B and hepatitis C infections (HBV/HCV) detected by online sexually transmitted infection (STI) testing services (e-services). We identify HBV/HCV infection rates among individuals using Sexual Health London (SHL), a large e-service.
Methods: SHL e-records of individuals receiving reactive HBsAg and/or HepCAb screening results between 1 January 2021 and 1 January 2022 were reviewed. Only at-risk groups are offered HBV/HCV testing, with risks captured via an online triage/consultation. Roche Cobas e801 HBV/HCV screening assay uses a cut-off index of reactivity (COI) to categorise results: low reactive (COI >1-9) and reactive (COI ≥10). SHL refers individuals with any reactive result for confirmatory testing (CT) at a sexual health clinic that provides hepatitis outpatient management. Clinic staff performing the CT access the shared SHL e-record and electronically take over the patient's care.
Results: 67, 718 HBV and 61 064 HCV tests were performed, representing 16% of all kit returns. HBV reactivity was 1.4% (922/67 718): 474 low-reactive, 302 reactive and 146 unconfirmed-reactive. HCV reactivity was 0.3% (163/61 064): 53 low-reactive, 99 reactive and 11 unconfirmed-reactive.Among individuals with reactive (COI ≥10) screening HBV results, 85% results confirmed, 12% negative and 3% unknown. For HCV, 79% results confirmed, 13% negative and 8% unknown. 57 out of 57 new HBV/HCV infections were electronically transferred. HBV prevalence was 299/67 718 (0.4%). The rate of previously undiagnosed cases detected was 40 out of 67 338 (0.06%) for HBV and 17 out of 61 016 (0.03%) for HCV.
Conclusions: 16% of SHL service users received targeted testing for hepatitis in 2021. Testing volumes significantly exceeded and new HBV/HCV diagnosis rates were similar to those reported by sentinel laboratory surveillance. 100% new infections transitioned to care, demonstrating effective integration between online and local sexual health services.
期刊介绍:
Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.