1
|
Irvin R, Ward K, Agee T, Nelson NP, Vellozzi C, Thomas DL, Millman AJ. Comparison of hepatitis C virus testing recommendations in high-income countries. World J Hepatol 2018; 10:743-751. [PMID: 30386467 PMCID: PMC6206144 DOI: 10.4254/wjh.v10.i10.743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate hepatitis C virus (HCV) testing recommendations from the United States and other high-income countries.
METHODS A comprehensive search for current HCV testing recommendations from the top quartile of United Nations Human Development Index (HDI) countries (very high HDI) was performed using Google and reviewed from May 1 - October 30, 2014 and re-reviewed April 1 - October 2, 2017.
RESULTS Of the 51 countries identified, 16 had HCV testing recommendations from a government body or recommendations issued collaboratively between a government and a medical organization. Of these 16 countries, 15 had HCV testing recommendations that were primarily risk-based and highlight behaviors, exposures, and conditions that are associated with HCV transmission in that region. In addition to risk-based testing, the HCV Guidance Panel (United States) incorporates recommendations for a one-time test for individuals born during 1945-1965 (the birth cohort) without prior ascertainment of risk into their guidance. In addition to the United States, six other countries either have an age-based testing recommendation or recommend one-time testing for all adults independent of risk factors typical of the region.
CONCLUSION This review affirmed the similarities of the HCV Guidance Panel’s guidance with those of recommendations from very high HDI countries.
Collapse
Affiliation(s)
- Risha Irvin
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
| | - Kathleen Ward
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
| | - Tracy Agee
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
| | - Noele P Nelson
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
| | - Claudia Vellozzi
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
| | - David L Thomas
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States
| | - Alexander J Millman
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA 30329, United States
| |
Collapse
|
2
|
Fill MA, Sizemore LA, Rickles M, Cooper KC, Buecker CM, Mullins HL, Hofmeister MG, Abara WE, Foster MA, Asher AK, Schaffner W, Dunn JR, Jones TF, Wester C. Epidemiology and risk factors for hepatitis C virus infection in a high-prevalence population. Epidemiol Infect 2018; 146:508-514. [PMID: 29429421 PMCID: PMC9134524 DOI: 10.1017/s0950268818000080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 12/01/2017] [Accepted: 01/04/2018] [Indexed: 02/01/2023] Open
Abstract
To understand increasing rates of hepatitis C virus (HCV) infection in Tennessee, we conducted testing, risk factor analysis and a nested case-control study among persons who use drugs. During June-October 2016, HCV testing with risk factor assessment was conducted in sexually transmitted disease clinics, family planning clinics and an addiction treatment facility in eastern Tennessee; data were analysed by using multivariable logistic regression. A nested case-control study was conducted to assess drug-using risks and behaviours among persons who reported intranasal or injection drug use (IDU). Of 4753 persons tested, 397 (8.4%) were HCV-antibody positive. HCV infection was significantly associated with a history of both intranasal and IDU (adjusted odds ratio (aOR) 35.4, 95% confidence interval (CI) 24.1-51.9), IDU alone (aOR 52.7, CI 25.3-109.9), intranasal drug use alone (aOR 2.6, CI 1.8-3.9) and incarceration (aOR 2.7, CI 2.0-3.8). By 4 October 2016, 574 persons with a reported history of drug use; 63 (11%) were interviewed further. Of 31 persons who used both intranasal and injection drugs, 26 (84%) reported previous intranasal drug use, occurring 1-18 years (median 5.5 years) before their first IDU. Our findings provide evidence that reported IDU, intranasal drug use and incarceration are independent indicators of risk for past or present HCV infection in the study population.
Collapse
Affiliation(s)
- M. A. Fill
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Tennessee Department of Health, Nashville, Tennessee, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - L. A. Sizemore
- Tennessee Department of Health, Nashville, Tennessee, USA
| | - M. Rickles
- Tennessee Department of Health, Nashville, Tennessee, USA
| | - K. C. Cooper
- Knox County Health Department, Knoxville, Tennessee, USA
| | - C. M. Buecker
- Chattanooga-Hamilton County Health Department, Chattanooga, Tennessee, USA
| | - H. L. Mullins
- Sullivan County Regional Health Department, Kingsport, Tennessee, USA
| | - M. G. Hofmeister
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - W. E. Abara
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - M. A. Foster
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - A. K. Asher
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - W. Schaffner
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - J. R. Dunn
- Tennessee Department of Health, Nashville, Tennessee, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - T. F. Jones
- Tennessee Department of Health, Nashville, Tennessee, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - C. Wester
- Tennessee Department of Health, Nashville, Tennessee, USA
| |
Collapse
|
3
|
Falade-Nwulia O, Mehta SH, Lasola J, Latkin C, Niculescu A, O’Connor C, Chaulk P, Ghanem K, Page KR, Sulkowski MS, Thomas DL. Public health clinic-based hepatitis C testing and linkage to care in Baltimore. J Viral Hepat 2016; 23:366-74. [PMID: 26840570 PMCID: PMC4836954 DOI: 10.1111/jvh.12507] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/09/2015] [Indexed: 12/13/2022]
Abstract
Testing and linkage to care are important determinants of hepatitis C virus (HCV) treatment effectiveness. Public health clinics serve populations at high risk of HCV. We investigated their potential to serve as sites for HCV testing, initiation of and linkage to HCV care. Cross-sectional study of patients accessing sexually transmitted infection (STI) care at the Baltimore City Health Department (BCHD) STI clinics, from June 2013 through April 2014 was conducted. Logistic regression was used to assess factors associated with HCV infection and specialist linkage to care. Between 24 June 2013 and 15 April 2014, 2681 patients were screened for HCV infection. Overall, 189 (7%) were anti-HCV positive, of whom 185 (98%) received follow-up HCV RNA testing, with 155 (84%) testing RNA positive. Of 155 RNA-positive individuals, 138 (89%) returned to the STI clinic for HCV RNA results and initial HCV care including counselling regarding transmission and harm reduction in alcohol, and 132 (85%) were referred to a specialist for HCV care. With provision of patient navigation services, 81 (52%) attended an offsite HCV specialist appointment. Alcohol use and lack of insurance coverage were associated with lower rates of specialist linkage (OR 0.4 [95% CI 0.1-0.9] and OR 0.4 [95% CI 0.1-0.9], respectively). We identified a high prevalence of HCV infection in BCHD STI clinics. With availability of patient navigation services, a large proportion of HCV-infected patients linked to off-site specialist care.
Collapse
Affiliation(s)
- Oluwaseun Falade-Nwulia
- Johns Hopkins University School of Medicine, Baltimore, MD,Baltimore City Health Department, Baltimore, MD
| | - Shruti H. Mehta
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | - Carl Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alex Niculescu
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cristi O’Connor
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Patrick Chaulk
- Baltimore City Health Department, Baltimore, MD,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Khalil Ghanem
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kathleen R Page
- Johns Hopkins University School of Medicine, Baltimore, MD,Baltimore City Health Department, Baltimore, MD
| | | | | |
Collapse
|
4
|
Fenton KA, Aquino GA, Dean HD. Program collaboration and service integration in the prevention and control of HIV infection, viral hepatitis, STDs, and tuberculosis in the U.S.: lessons learned from the field. Public Health Rep 2014; 129 Suppl 1:1-4. [PMID: 24385642 DOI: 10.1177/00333549141291s101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Kevin A Fenton
- Gustavo Aquino is the Associate Director for Program Integration, Hazel Dean is the Deputy Director, and Kevin Fenton is the former Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia
| | - Gustavo A Aquino
- Gustavo Aquino is the Associate Director for Program Integration, Hazel Dean is the Deputy Director, and Kevin Fenton is the former Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia
| | - Hazel D Dean
- Gustavo Aquino is the Associate Director for Program Integration, Hazel Dean is the Deputy Director, and Kevin Fenton is the former Director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia
| |
Collapse
|
5
|
Hechter RC, Jacobsen SJ, Luo Y, Nomura JH, Towner WJ, Tartof SY, Tseng HF. Hepatitis B testing and vaccination among adults with sexually transmitted infections in a large managed care organization. Clin Infect Dis 2014; 58:1739-45. [PMID: 24571863 DOI: 10.1093/cid/ciu103] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Data on viral hepatitis B (HBV) testing and vaccination in primary care settings among persons at sexual risk for HBV infection have been sparse. We examined rates and factors associated with HBV serologic testing and vaccination rates in adults infected with sexually transmitted infections. We conducted a retrospective cohort study of adults diagnosed with chlamydia, gonorrhea, or syphilis in Kaiser Permanente Southern California in 2008-2011. The vaccine series initiation was examined in subjects who were tested susceptible. The 90-day hepatitis B surface antigen (HBsAg) testing rate was 28.1% in 15 357 adults. Testing rates increased through the study period. Only 8.8% of patients received both HBsAg and hepatitis B surface antibody tests to determine prior exposure and susceptibility to HBV. Among those who were tested susceptible, 116 (10.6%) subjects initiated the vaccine series. In multivariable logistic regression analysis, the odds of receiving testing was inversely associated with female sex, black race, other/unknown race, or having prespecified chronic comorbidities. In survival analysis, adults aged 25-34 years and ≥55 years were more likely to initiate hepatitis B vaccine series compared with those aged 18-24 years. There are missed opportunities in HBV testing and vaccination in primary care. Implementation of provider decision-making support tools in the electronic medical record system may potentially improve hepatitis B testing and vaccination rates.
Collapse
Affiliation(s)
- Rulin C Hechter
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Steven J Jacobsen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Yi Luo
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Jim H Nomura
- Division of Infectious Disease, Southern California Permanente Medical Group, Los Angeles
| | - William J Towner
- Division of Infectious Disease, Southern California Permanente Medical Group, Los Angeles
| | - Sara Y Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Hung Fu Tseng
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena
| |
Collapse
|
6
|
Zuure FR, Urbanus AT, Langendam MW, Helsper CW, van den Berg CHSB, Davidovich U, Prins M. Outcomes of hepatitis C screening programs targeted at risk groups hidden in the general population: a systematic review. BMC Public Health 2014; 14:66. [PMID: 24450797 PMCID: PMC4016146 DOI: 10.1186/1471-2458-14-66] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 01/10/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Effective screening programs are urgently needed to provide undiagnosed hepatitis C virus (HCV)-infected individuals with therapy. This systematic review of characteristics and outcomes of screening programs for HCV focuses on strategies to identify HCV risk groups hidden in the general population. METHODS We conducted a comprehensive search of MEDLINE and EMBASE databases for articles published between 1991-2010, including studies that screened the general population using either a newly developed (nonintegrated) screening program or one integrated in existing health care facilities. Look-back studies, prevalence studies, and programs targeting high-risk groups in care (e.g., current drug users) were excluded. RESULTS After reviewing 7052 studies, we identified 67 screening programs: 24 nonintegrated; 41 programs integrated in a variety of health care facilities (e.g., general practitioner); and 2 programs with both integrated and nonintegrated strategies. Together, these programs identified approximately 25,700 HCV-infected individuals. In general, higher HCV prevalence was found in programs in countries with intermediate to high HCV prevalence, in psychiatric clinics, and in programs that used a prescreening selection based on HCV risk factors. Only 6 programs used a comparison group for evaluation purposes, and 1 program used theory about effective promotion for screening. Comparison of the programs and their effectiveness was hampered by lack of reported data on program characteristics, clinical follow-up, and type of diagnostic test. CONCLUSIONS A prescreening selection based on risk factors can increase the efficiency of screening in low-prevalence populations, and we need programs with comparison groups to evaluate effectiveness. Also, program characteristics such as type of diagnostic test, screening uptake, and clinical outcomes should be reported systematically.
Collapse
Affiliation(s)
- Freke R Zuure
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
| | - Anouk T Urbanus
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
- Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (University of Amsterdam), P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
| | - Miranda W Langendam
- Dutch Cochrane Centre, Academic Medical Center, P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
| | - Charles W Helsper
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, Utrecht 3508 GA, The Netherlands
| | - Charlotte HSB van den Berg
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
- Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (University of Amsterdam), P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
| | - Udi Davidovich
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
| | - Maria Prins
- Public Health Service of Amsterdam, the Netherlands, Infectious Diseases Cluster, P.O. Box 2200, Amsterdam 1000 CE, The Netherlands
- Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (University of Amsterdam), P.O. Box 22660, Amsterdam 1100 DD, The Netherlands
| |
Collapse
|
7
|
Frerichs W, Kaltenbacher E, van de Leur JP, Dean E. Can physical therapists counsel patients with lifestyle-related health conditions effectively? A systematic review and implications. Physiother Theory Pract 2012; 28:571-87. [DOI: 10.3109/09593985.2011.654179] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
8
|
Abstract
Less than half of gay and bisexual men indicated they had received some doses of hepatitis B virus vaccine. Hepatitis B virus vaccination was higher among men who were 18 to 29 years old (compared to those 50-59 years old), gay, or had received flu vaccine within the last year.
Collapse
Affiliation(s)
- Paul L. Reiter
- UNC Gillings School of Global Public Health
- Lineberger Comprehensive Cancer Center
| | - Noel T. Brewer
- UNC Gillings School of Global Public Health
- Lineberger Comprehensive Cancer Center
| |
Collapse
|
9
|
Miriti MK, Billah K, Weinbaum C, Subiadur J, Zimmerman R, Murray P, Gunn R, Buffington J. Economic benefits of hepatitis B vaccination at sexually transmitted disease clinics in the U.S. Public Health Rep 2008; 123:504-13. [PMID: 18763413 DOI: 10.1177/003335490812300412] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study assessed the long-term economic implications of a national program to vaccinate all adults treated at sexually transmitted disease (STD) clinics in a single year. METHODS A model was developed to track the long-term disease outcomes and costs among a hypothetical cohort of 2 million STD clinic clients accessing services in one year, using data from published sources and demonstration projects at STD clinics in San Diego (California), Illinois, and Denver (Colorado). The model estimated net economic benefits of a routine hepatitis B vaccination policy at STD clinics nationwide compared with no vaccination. RESULTS Without a vaccination program, an estimated 237,021 new hepatitis B virus (HBV) infections would occur over the lifetimes of the 2 million STD clinic clients seen in a single year. HBV-related medical costs and productivity losses would be $1.6 billion. In a national program for routine vaccination at STD clinics, 1.3 million adults would be expected to receive at least one vaccine dose, and an estimated 45% of the new HBV infections expected without vaccination would be prevented. The vaccination program would cost $138 million, HBV infections occurring despite the program would cost $878 million, and clients' time and travel would cost $45 million. The net economic benefit (savings) of routine vaccination would be $526 million. If the indirect costs of lost productivity due to HBV infection are not considered, routine vaccination would have a net cost of $28 million. CONCLUSIONS Estimates from this model suggest a national program for routine hepatitis B vaccination of adults at STD clinics would be a cost saving to society.
Collapse
Affiliation(s)
- M'Kiaira K Miriti
- Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Ward JW. Before It Is Too Late: Hepatitis B Vaccination for All STD Clients. Sex Transm Dis 2007; 34:669-70. [PMID: 17717484 DOI: 10.1097/olq.0b013e318149243d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
Honeycutt AA, Harris JL, Khavjou O, Buffington J, Jones TS, Rein DB. The costs and impacts of testing for hepatitis C virus antibody in public STD clinics. Public Health Rep 2007; 122 Suppl 2:55-62. [PMID: 17542455 PMCID: PMC1831797 DOI: 10.1177/00333549071220s211] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To estimate the cost and cost-effectiveness of testing sexually transmitted disease (STD) clinic subgroups for antibodies to hepatitis C virus (HCV). METHODS HCV counseling, testing, and referral (CTR) costs were estimated using data from two STD clinics and the literature, and are reported in 2006 dollars. Effectiveness of HCV CTR was defined as the estimated percentage of clinic clients in subgroups targeted for HCV antibody (anti-HCV) testing who had a true positive test and returned for their test results. We estimated the cost per true positive injection drug user (IDU) who returned for anti-HCV test results and the cost-effectiveness of expanding HCV CTR to non-IDU subgroups. RESULTS The estimated cost per true positive IDU who returned for test results was $54. The cost-effectiveness of expanding HCV CTR to non-IDU subgroups ranged from $179 to $2,986. Our estimates were most sensitive to variations in HCV prevalence, the cost of testing, and the rate of client return. CONCLUSIONS Based on national data, testing IDUs in the STD clinic setting is highly cost-effective. Some clinics may find that it is cost-effective to expand testing to non-IDU men older than 40 who report more than 100 lifetime sex partners. STD clinics can use study estimates to assess the feasibility and desirability of expanding HCV CTR beyond IDUs.
Collapse
|
12
|
Zevin B. Managing chronic hepatitis C in primary-care settings: more than antiviral therapy. Public Health Rep 2007; 122 Suppl 2:78-82. [PMID: 17542459 PMCID: PMC1831801 DOI: 10.1177/00333549071220s215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Barry Zevin
- Tom Waddell Health Center, San Francisco Department of Public Health, San Francisco, CA, USA.
| |
Collapse
|
13
|
McLaughlin P. Viral hepatitis vaccination in an opioid treatment program: Hartford, Connecticut, 2002-2005. Public Health Rep 2007; 122 Suppl 2:48-51. [PMID: 17542453 PMCID: PMC1831815 DOI: 10.1177/00333549071220s209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hartford Dispensary, a private, not-for-profit behavioral health care organization specializing in opioid treatment program services, serves more than 4,200 clients per day in seven licensed facilities. In May 2002, the Dispensary began offering free combined hepatitis A and B vaccine for all eligible clients in two Hartford clinics. Initial eligibility criteria required a client to be hepatitis C antibody positive, hepatitis B virus (HBV) surface antigen (HBsAg) negative, not pregnant, and not have a contraindication due to a medical condition. From May 2002 through April 2005, 5,419 doses of combined vaccine were given. Of the 2,072 clients who received a first dose, 92% (1,914) received the second dose and 69% (1,433) completed the series. Long treatment duration, frequent client visits, availability of medical staff, and counseling support contributed to high rates of combined vaccine series completion in the two programs. Opioid treatment programs appear to be good settings in which to provide hepatitis vaccination for high-risk adults.
Collapse
|
14
|
Ward JW, Fenton KA. CDC and progress toward integration of HIV, STD, and viral hepatitis prevention. Public Health Rep 2007; 122 Suppl 2:99-101. [PMID: 17542464 PMCID: PMC1831806 DOI: 10.1177/00333549071220s220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- John W Ward
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (proposed), Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | |
Collapse
|
15
|
Arora S, Thornton K, Jenkusky SM, Parish B, Scaletti JV. Project ECHO: linking university specialists with rural and prison-based clinicians to improve care for people with chronic hepatitis C in New Mexico. Public Health Rep 2007; 122 Suppl 2:74-7. [PMID: 17542458 PMCID: PMC1831800 DOI: 10.1177/00333549071220s214] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Project Extension for Community Healthcare Outcomes (Project ECHO) is a telemedicine and distance-learning program designed to improve access to quality health care for New Mexicans with hepatitis C. Project ECHO links health-care providers from rural clinics, the Indian Health Service, and prisons with specialists at the University of New Mexico. At weekly clinics, partners present and discuss patients with hepatitis C with specialists. Partners can receive continuing education credits for participating. Since June 2003, 173 hepatitis C clinics have been conducted with 1,843 case presentations. Partners have received 390 hours of training and 2,997 hours of continuing education credits. And in 2006, the State Legislature approved $1.5 million in annual funding for the project. Project ECHO has increased access to state-of-the art hepatitis C virus care for patients living in rural areas or prisons. Because of its success with hepatitis C, this project is being expanded to other chronic medical conditions.
Collapse
Affiliation(s)
- Sanjeev Arora
- University of New Mexico School of Medicine, Albuquerque, NM 87131-0001, USA.
| | | | | | | | | |
Collapse
|
16
|
Buffington J, Jones TS. Integrating viral hepatitis prevention into public health programs serving people at high risk for infection: good public health. Public Health Rep 2007; 122 Suppl 2:1-5. [PMID: 17542445 PMCID: PMC1831807 DOI: 10.1177/00333549071220s201] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Joanna Buffington
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | | |
Collapse
|
17
|
Whiticar P, Liberti T. Advancing integration of HIV, STD, and viral hepatitis services: state perspectives. Public Health Rep 2007; 122 Suppl 2:91-5. [PMID: 17542462 PMCID: PMC1831804 DOI: 10.1177/00333549071220s218] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Peter Whiticar
- STD/AIDS Prevention Branch, Hawaii Department of Health, Honolulu, HI, USA.
| | | |
Collapse
|
18
|
Harris JL, Jones TS, Buffington J. Hepatitis B vaccination in six STD clinics in the United States committed to integrating viral hepatitis prevention services. Public Health Rep 2007; 122 Suppl 2:42-7. [PMID: 17542452 PMCID: PMC1831814 DOI: 10.1177/00333549071220s208] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Hepatitis B vaccination is recommended for clients of sexually transmitted disease (STD) clinics. The Healthy People 2010 goal is for 90% of STD clinics to offer hepatitis B vaccine to all unprotected clients. This report describes hepatitis B vaccination trends in six STD clinics in the United States and discusses implications for policy and practice. METHODS We conducted a retrospective study in six STD clinics to evaluate hepatitis B vaccination. We collected data on client visits and hepatitis B vaccinations for the period 1997-2005. To compare clinics, we calculated vaccination rates per 100 client visits. We interviewed staff to explore factors associated with hepatitis B vaccination trends. RESULTS STD clinic client visits ranged from 2,883 to 23,109 per year. The median rate of hepatitis B vaccination was 28 per 100 client visits. Vaccination rates declined in all six clinics in later years, which was associated with eligibility restrictions caused by fiscal problems and increasing levels of prior vaccination. The median rate of vaccine series completion was 30%. Staff cited multiple provider- and client-level barriers to series completion. CONCLUSIONS This study shows that STD clinics can implement hepatitis B vaccination and reach large numbers of high-risk adults. Adequate funding and vaccine supply are needed to implement current federal recommendations to offer hepatitis B vaccine to adults seen in STD clinics and to achieve the Healthy People 2010 objective.
Collapse
|