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Martyn E, O'Regan S, Harris P, Leonard M, Veitch M, Sultan B, Matthews PC, Ghosh I, Story A, Surey J. Hepatitis B virus (HBV) screening, linkage and retention-in-care in inclusion health populations: Evaluation of an outreach screening programme in London. J Infect 2024; 88:167-172. [PMID: 38159579 PMCID: PMC7615690 DOI: 10.1016/j.jinf.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES We evaluated a hepatitis B virus (HBV) screening programme, delivered by a specialist pan-London multidisciplinary outreach team, to understand population characteristics and care cascade among people who experience extreme social exclusion (Inclusion Health (IH) groups). METHODS Point-of-care HBV screening was performed in temporary accommodation for people experiencing homelessness (PEH) and people seeking asylum (initial accommodation centres, IACs) via a mobile unit staffed by peers with lived experience, nurses, and doctors. We analysed demographics and HBV characteristics of adults screened between May 2020 and January 2022. We ascertained linkage-to-care (LTC), retention-in-care (RIC) and loss-to-follow-up (LTFU). People LTFU were contacted by peers to re-engage in care. RESULTS 2473 people were screened: 809 in IACs, 1664 in other temporary accommodation. Overall hepatitis B surface antigen (HBsAg) prevalence was 1.7% (43/2473), highest in IACs (3.5%, 28/809). LTC within 3 months was 56% (24/43) and RIC, 87% (26/30). LTC was higher when referred to a local IH-specialist hepatitis service, compared to other services (77%, 17/22 vs 33%, 7/21; p = 0.006). LTFU was 30% (13/43), reduced to 21% (9/43) after intervention by peers. CONCLUSION Our findings support outreach screening among IH populations and peer-supported linkage to IH-specialist hepatitis services. We recommend increased HBV testing and HBV-specific IH specialist services.
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Affiliation(s)
- Emily Martyn
- London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK; The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK.
| | - Sive O'Regan
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Philippa Harris
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Mark Leonard
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Martha Veitch
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Binta Sultan
- Mortimer Market Centre, Central and North London NHS Foundation Trust, Capper Street, London WC1E 6JB, UK; Institute of Global Health, University College London, Gower St, London WC1E 6BT, UK
| | - Philippa C Matthews
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK; Mortimer Market Centre, Central and North London NHS Foundation Trust, Capper Street, London WC1E 6JB, UK; Division of Infection and Immunity, University College London, Gower St, London WC1E 6BT, UK; Department of Infectious Diseases, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK
| | - Indrajit Ghosh
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK; Mortimer Market Centre, Central and North London NHS Foundation Trust, Capper Street, London WC1E 6JB, UK
| | - Alistair Story
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK; Collaborative Centre for Inclusion Health, University College London, Gower St, London WC1E 6BT, UK
| | - Julian Surey
- Find & Treat Service, Division of Infection, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2BU, UK; Institute of Global Health, University College London, Gower St, London WC1E 6BT, UK; Universidad Autonoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain
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