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Diagnosis of Hepatitis C Virus Infection in Spain: an Opportunity to Improve

Enfermedades infecciosas y microbiología clínica(2019)

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Abstract
BACKGROUND:Reflex testing of antibodies and viral load in the same sample for diagnosing hepatitis C virus infection speeds up access to treatment. However, how hepatitis C is diagnosed in Spanish hospitals is unknown.OBJECTIVE:To describe the available resources and procedures for the diagnosis of hepatitis C virus infection in Spain.METHODS:Survey sent to public and private Spanish hospitals with teaching accreditation with at least 200 beds.RESULTS:Of the 160 hospitals that met the inclusion criteria, 90 centres (response rate 56.3%) completed the survey. Two hospitals (2.2%) have no diagnostic resources, 15 (16.7%) can only test for anti-hepatitis C virus(Ab), 9 (10.0%) for Ab and viral load, 47 (52.2%) for Ab, viral load and genotype, 2 (2.2%) for Ab, viral load and core antigen, and 15 (16.7%) can perform Ab, core antigen, viral load and genotype tests. When an Ab test is positive, 28 (31.1%) hospitals perform reflex testing. When an active infection is diagnosed, some communication strategy is used in 62 (68.9%) hospitals. Approximately 44.2% of the respondents believe that all determinations needed to reach a definitive diagnosis should be done on a single blood sample.CONCLUSION:Although 81% of Spanish hospitals have the resources to perform reflex hepatitis C virus infection testing, it is only done in 31%, and less than a half of respondents believe that the definitive diagnosis should be performed on a single sample.
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Key words
Hepatitis C,Diagnostic tests,Variability,Reflex testing,HCV
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