| Title |
Hepatitis virus (HCV) diagnosis and access to treatment in a UK cohort
|
|---|---|
| Published in |
BMC Infectious Diseases, September 2018
|
| DOI | 10.1186/s12879-018-3367-3 |
| Pubmed ID | |
| Authors |
Emily Adland, Gerald Jesuthasan, Louise Downs, Victoria Wharton, Gemma Wilde, Anna L. McNaughton, Jane Collier, Eleanor Barnes, Paul Klenerman, Monique Andersson, Katie Jeffery, Philippa C. Matthews |
| Abstract |
As direct acting antiviral (DAA) therapy is progressively rolled out for patients with hepatitis C virus (HCV) infection, careful scrutiny of HCV epidemiology, diagnostic testing, and access to care is crucial to underpin improvements in delivery of treatment, with the ultimate goal of elimination. We retrospectively studied microbiology records from a large UK teaching hospital in order to compare the performance of HCV screening and diagnostic tests (antibody, antigen and HCV RNA detection). Having described a local cohort of adults with active HCV infection, we investigated the proportion who attended hospital appointments, were prescribed direct acting antiviral (DAA) therapy, and cleared HCV RNA following treatment. Over a total time period of 33 months between 2013 and 2016, we tested 38,509 individuals for HCV infection and confirmed a new diagnosis of active HCV infection (HCV-Ag + and/or HCV RNA+) in 353 (positive rate 0.9%). Our in-house HCV-Ab screening test had a positive predictive value of 87% compared to repeat HCV-Ab testing in a reference laboratory, highlighting the potential for false positives to arise using this test. HCV-Ag had 100% positive predictive value compared to detection of HCV RNA. There was a strong correlation between quantitative HCV-Ag and HCV RNA viral load (p < 0.0001). Among the cases of infection, genotype-1 and genotype-3 predominated, the median age was 37 years, 84% were male, and 36% were in prison. Hepatology review was provided in 39%, and 22% received treatment. Among those who received DAA therapy with 12 weeks of follow-up, 93% achieved a sustained virologic response (SVR12). HCV-Ag performs well as a diagnostic test compared to PCR for HCV RNA. Active HCV infection is over-represented among men and in the prison population. DAA therapy is successful in those who receive it, but a minority of patients with a diagnosis of HCV infection access clinical care. Enhanced efforts are required to provide linkage to clinical care within high risk populations. |
X Demographics
The data shown below were collected from the profiles of 7 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 3 | 43% |
| Venezuela, Bolivarian Republic of | 1 | 14% |
| Unknown | 3 | 43% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 5 | 71% |
| Practitioners (doctors, other healthcare professionals) | 1 | 14% |
| Members of the public | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 47 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 11% |
| Other | 4 | 9% |
| Student > Bachelor | 4 | 9% |
| Student > Ph. D. Student | 3 | 6% |
| Student > Doctoral Student | 3 | 6% |
| Other | 6 | 13% |
| Unknown | 22 | 47% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 17% |
| Immunology and Microbiology | 4 | 9% |
| Nursing and Health Professions | 2 | 4% |
| Social Sciences | 2 | 4% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Other | 4 | 9% |
| Unknown | 26 | 55% |
Attention Score in Context
This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 September 2018.
All research outputs
#5,609,670
of 23,103,436 outputs
Outputs from BMC Infectious Diseases
#1,664
of 7,752 outputs
Outputs of similar age
#97,571
of 337,432 outputs
Outputs of similar age from BMC Infectious Diseases
#32
of 157 outputs
Altmetric has tracked 23,103,436 research outputs across all sources so far. Compared to these this one has done well and is in the 75th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 7,752 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.3. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 337,432 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.
We're also able to compare this research output to 157 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 79% of its contemporaries.