HIV and HCV screening by non-infectious diseases physicians: can we improve testing and hidden infection rates?

Missed opportunities for Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) testing remain high. We aimed to ascertain the knowledge of screening guidelines and attitudes of non-infectious disease (ID) hospital physicians and assess the impact of a 1-h session on screening rates and diag...

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Published in:	Frontiers in public health Vol. 11; p. 1136988
Main Authors:	García-Ruiz de Morales, Alejandro G, Martínez-Sanz, Javier, Vivancos-Gallego, María J, Sánchez-Conde, Matilde, Vélez-Díaz-Pallarés, Manuel, Romero-Hernández, Beatriz, Vázquez, María Dolores González, de Luque, Carmen María Cano, González-Sarria, Ander, Galán, Juan Carlos, Rodríguez, Francisco Gea, Moreno, Santiago, Pérez-Elías, María Jesús
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 26-06-2023
Subjects:	formative session HCV testing Hepacivirus Hepatitis C - diagnosis Hepatitis C - epidemiology HIV Infections - diagnosis HIV Infections - epidemiology HIV testing hospital intervention Humans missed opportunities Noncommunicable Diseases Physicians Public Health screening diagnostic screening programs late diagnosis screening formative session missed opportunities HIV testing HCV testing hospital intervention
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Summary:	Missed opportunities for Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) testing remain high. We aimed to ascertain the knowledge of screening guidelines and attitudes of non-infectious disease (ID) hospital physicians and assess the impact of a 1-h session on screening rates and diagnoses. This interventional study consisted of a 1-h training session on HIV and HCV epidemiology and testing guidelines for non-ID physicians. Pre-and post-session questionnaires compared the knowledge of the guidelines and attitudes toward screening before and after the session. Rates of screening and diagnoses were compared in three 6 months periods: before, immediately after, and 24 months ±4 after the session. A total of 345 physicians from 31 departments participated in these sessions. Before the session, 19.9% (28% medical, 8% surgical) and 17.9% (30% medical, 2.7% surgical) were aware of HIV and HCV testing guidelines, respectively. The willingness to routinely test increased from 5.6 to 22%, whereas not ordering tests decreased from 34.1 to 2.4%. HIV screening rates significantly increased by 20% after the session (7.7 vs. 9.3 tests per 103 patients; < 0.001), and the effect persisted until the long-term period. The HIV diagnosis rate increased globally (3.6 vs. 5.2 HIV diagnoses per 105 patients; = 0.157), mainly because of medical services (4.7 vs. 7.7 per 105 patients; = 0.082). The HCV screening rate increased significantly immediately and in the long term only in medical services (15.7 and 13.6%, respectively). The new active HCV infection rates increased immediately and declined steeply thereafter. A short session for non-ID physicians can improve HIV/HCV screening, increase diagnosis, and contribute to disease elimination.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors have contributed equally to this work Reviewed by: Héctor Armando Rincón León, Mexican Social Security Institute (IMSS), Mexico; Benedetto Maurizio Celesia, UOC Infectious Diseases ARNAS Garibaldi, Italy Edited by: Mamta K. Jain, University of Texas Southwestern Medical Center, United States
ISSN:	2296-2565 2296-2565
DOI:	10.3389/fpubh.2023.1136988