Julie Bottero1,2, Cécile Brouard3, Françoise Roudot-Thoraval4, Sylvie Deuffic-Burban5,6,7,8, Philippe Hofliger9, Armand Abergel10, Johann Volant11, Daniel Dhumeaux12, Yazdan Yazdanpanah5,6,13. 1. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France. julie.bottero@aphp.fr. 2. AP-HP, Hôpital St Antoine, Service de Maladies Infectieuses, Paris, France. julie.bottero@aphp.fr. 3. Département des Maladies Infectieuses, Institut de veille sanitaire, Saint-Maurice, France. 4. AP-HP, Groupe Hospitalier Henri Mondor, Service de Santé Publique, Université Paris-Est-Créteil, Créteil, France. 5. INSERM, IAME, UMR 1137, Paris, France. 6. Univ Paris Diderot, Sorbonne Paris Cité, Paris, France. 7. Inserm, LIRIC-UMR995, Lille, France. 8. Univ Lille, Lille, France. 9. Département d'Enseignement et de Recherche en Médecine Générale, Université de Nice Sophia Antipolis, Nice, France. 10. CHU de Clermont-Ferrand - Hôpital d'Estaing, Service d'hépato-gastro-entérologie, Clermont-Ferrand, France. 11. Fédération Sos hépatites, Paris, France. 12. AP-HP, Groupe Hospitalier Henri Mondor, Service d'Hépato-Gastro-Entérologie, Université Paris-Est-Créteil, Créteil, France. 13. AP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses, Paris, France.
Abstract
BACKGROUND & AIMS: Worldwide and, to a lesser extent, in France, a minority of individuals infected with hepatitis B (HBV) and C (HCV) is aware of its status. Given the current availability of highly effective anti-HBV and anti-HCV agents, the high rate of undiagnosed people, associated with individual and community prejudices (liver disease worsening, persistence of a hidden transmission reservoir and medicoeconomic burden of delayed care), is unacceptable. METHODS: On the occasion of the first French general report on viral hepatitis, new recommendations for HBV and HCV testing were issued. We aim to introduce the new French strategy for HBV and HCV screening, and to describe the underlying epidemiological data. RESULTS: These recommendations comprise various items. First, the screening of chronic viruses, namely HBV, HCV and HIV, should be quasi-systematically combined. Second, the targeted screening of groups at risk of viral exposure must be strengthened. Third, routine testing for each of these three viruses should be offered at least once to men of 18-60 years old who had never been tested. In parallel, in pregnant women, in addition to HIV-HBV screening, currently recommended HCV testing should be routinely performed during the first trimester of pregnancy. In order to best achieve the target populations, community initiatives that propose testing actions should be encouraged, particularly those including rapid point-of-care tests. CONCLUSIONS: Overall, these recommendations aim to define a comprehensive testing strategy for chronic viral infections, emphasizing both targeted screening and mass screening and considering jointly HBV, HCV and HIV.
BACKGROUND & AIMS: Worldwide and, to a lesser extent, in France, a minority of individuals infected with hepatitis B (HBV) and C (HCV) is aware of its status. Given the current availability of highly effective anti-HBV and anti-HCV agents, the high rate of undiagnosed people, associated with individual and community prejudices (liver disease worsening, persistence of a hidden transmission reservoir and medicoeconomic burden of delayed care), is unacceptable. METHODS: On the occasion of the first French general report on viral hepatitis, new recommendations for HBV and HCV testing were issued. We aim to introduce the new French strategy for HBV and HCV screening, and to describe the underlying epidemiological data. RESULTS: These recommendations comprise various items. First, the screening of chronic viruses, namely HBV, HCV and HIV, should be quasi-systematically combined. Second, the targeted screening of groups at risk of viral exposure must be strengthened. Third, routine testing for each of these three viruses should be offered at least once to men of 18-60 years old who had never been tested. In parallel, in pregnant women, in addition to HIV-HBV screening, currently recommended HCV testing should be routinely performed during the first trimester of pregnancy. In order to best achieve the target populations, community initiatives that propose testing actions should be encouraged, particularly those including rapid point-of-care tests. CONCLUSIONS: Overall, these recommendations aim to define a comprehensive testing strategy for chronic viral infections, emphasizing both targeted screening and mass screening and considering jointly HBV, HCV and HIV.
Authors: Anna Maria Geretti; Harrison Austin; Giovanni Villa; Dan Hungerford; Colette Smith; Paula Davies; Jillian Williams; Apostolos Beloukas; Wojciech Sawicki; Mark Hopkins Journal: Sci Rep Date: 2018-10-17 Impact factor: 4.379