ArticlePloS one2018
An innovative approach to increase viral hepatitis diagnoses and linkage to care using opt-out testing and an integrated care pathway in a London Emergency Department.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Blood-borne virus testing in European emergency departments: current evidence and service considerations.European journal of public health · 2025Pooled it
- Daily polysubstance use associated with HIV, HCV, and non-fatal overdose among people who inject drugs: A latent class analysis using nationwide data.Drug and alcohol dependence · 2026Article
- Viral hepatitis detection through emergency hospital departments in a Spanish region with high immigration: implications for elimination strategies.Infectious diseases of poverty · 2026Observational
- Acceptability of automatic screening for viral hepatitis in an emergency department setting: patient and healthcare worker perspectives.Internal medicine journal · 2025Article
- Review
- A scoping review on HCV screening strategies: population to screen and the test types.BMC public health · 2025Article
- The Key Importance of Screening Underprivileged People in Order to Achieve Global Hepatitis Virus Elimination Targets.Viruses · 2025Review
- HBV and HCV testing outcomes among marginalized communities in Italy, 2019-2024: a prospective study.The Lancet regional health. Europe · 2025Article
- Enhancing Hepatitis C Virus Testing, Linkage to Care, and Treatment Commencement in Hospitals: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2025Article
- Linkage to Care of People With Chronic Hepatitis B Virus and Hepatitis C Virus Infection Among Blood Donors: Experience From an Apex Treatment Centre Under National Viral Hepatitis Control Program, India.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Prevalence, characteristics and challenges of late HIV diagnosis in Germany: an expert narrative review.Infection · 2023Review
- Hospital-based preventative interventions for people experiencing homelessness in high-income countries: A systematic review.EClinicalMedicine · 2022Review
- Universal testing for hepatitis B and hepatitis C in the emergency department: a cost-effectiveness and budget impact analysis of two urban hospitals in the United Kingdom.Cost effectiveness and resource allocation : C/E · 2022Article
- Real-world clinical effectiveness and sustainability of universal bloodborne virus testing in an urban emergency department in the UK.Scientific reports · 2022Article
- VirA+EmiC project: Evaluating real-world effectiveness and sustainability of integrated routine opportunistic hepatitis B and C testing in a large urban emergency department.Journal of viral hepatitis · 2022Article
- Article
- Opt-out universal HCV and HIV screening in a Canadian emergency room: a cross-sectional study.BMJ open · 2022Article
- Optimizing diagnostic algorithms to advance Hepatitis C elimination in Italy: A cost effectiveness evaluation.Liver international : official journal of the International Association for the Study of the Liver · 2022Article
- Screening for Chronic Infectious Diseases by Serology in Those Presenting with Malaria in London, United Kingdom.The American journal of tropical medicine and hygiene · 2021Article
- HCV core antigen plays an important role in the fight against HCV as an alternative to HCV-RNA detection.Journal of clinical laboratory analysis · 2021Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Therapies that halt progression of chronic hepatitis B virus (HBV) and achieve a cure for chronic hepatitis C virus (HCV) have encouraged development of innovative strategies to diagnose and link patients to care. We describe the prevalence and risk factors for HBV and HCV infections and use of an opt-out hepatitis testing and integrated linkage to care pathway in a London Emergency Department (ED). ED patients aged ≥16 years having routine blood tests from 15 February-28 March 2016 were tested for hepatitis, unless opted out. Hepatitis B surface antigen (HBsAg) and hepatitis C antibody tests (HCV-Ab, including a confirmatory hepatitis C antigen test (HCV-Ag)) were pre-selected on electronic blood test requests. Linkage to care (attending one clinic appointment) was offered to HBsAg and HCV-Ag patients (new or known-disengaged with care diagnoses). Weighted prevalence estimates and risk factors for seropositivity adjusted by demographics and survey weights were calculated using logistic regression. Hepatitis testing uptake was 56% (3,290/5,865). Overall, 26 HBsAg (10 new diagnoses) and 63 HCV-Ab patients were identified of which 32 were HCV-Ag positive (10 new diagnoses). Weighted seroprevalence of HBsAg was 0.50% (95% CI 0.3-0.8%); HCV-Ab 2.0% (95% CI 1.5-2.7%) and HCV-Ag 1.2% (95% CI 0.8-1.7%). Risk factors for infection were being male (HBsAg: aOR 4.1, 95% CI 1.5-11.3), of non-White British ethnicity (HBsAg: aOR>11) or being homeless (HCV-Ag: aOR 18.9, 95% CI 6.9-51.4). We achieved a high linkage to care uptake for HBsAg (93%) and HCV-Ag (78%) among patients who were contacted and required linkage. A pre-selected hepatitis testing ordering system facilitated a high testing uptake. New and disengaged with care diagnoses and a high HCV prevalence were identified demonstrating the potential to identify and link patients to care in this setting. Strategies connecting clinical care with community outreach services are key for improving patient linkage to care.
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