Universal screening for viral hepatitis in all inpatients of a university internal medicine department

对大学内科所有住院患者进行病毒性肝炎普遍筛查

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Abstract

BACKGROUND: The global medical community has set a goal of reducing the prevalence of viral hepatitis by 2030, focusing on screening large segments of the population who are unaware of being infected. This study aimed to investigate the efficacy of screening hospitalized patients for viral hepatitis. METHOD: All patients hospitalized in an internal medicine department between January 2021 and September 2023 underwent screening for hepatitis B and C (HBV/C). RESULTS: A total of 3914 patients were screened (mean age 69.8±16.9 years). A total of 112 (2.9%) patients had positive surface antigen, and 1281 (32.8%) patients had evidence of prior HBV infection (anti-HBc+), of whom the majority (952, 74.4%) also had concurrent positive anti-HBs antibodies. HBV DNA testing was performed in 65 patients (58%), with 60 patients (92.3%) showing detectable HBV DNA levels. Of these, 13 had chronic HBV infection, and 47 had chronic HBV hepatitis. Finally, 28 patients (71.8% of eligible patients) received treatment. During screening for HCV, 102 patients (2.7%) were anti-HCV(+), and 53 patients (52%) underwent HCV RNA testing. Twenty-nine patients showed detectable HCV RNA levels (54.7%), with 13 patients eventually receiving treatment (52% of eligible patients). CONCLUSIONS: Screening for viral hepatitis can be easily and effectively performed in hospitalized patients. However, significant care should be taken to ensure that all patients undergo the entire screening process and receive treatment when eligible. Additionally, a substantial proportion of patients with previous HBV infection was recorded, which is of considerable importance in the era of immunosuppressive therapies.

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