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Screening people admitted to hospital with COVID-19 for hepatitis C or hepatitis B does not lead to detection of a large number of undiagnosed infections and is likely to be of limited use in reducing the number of undiagnosed infections, Spanish researchers have concluded after evaluating screening outcomes in 2020.
Their evaluation findings, published in the journal Gastroenterologia y Hepatologia, show that just three chronic hepatitis C infections were detected among 4662 people with COVID-19 admitted to hospitals in Leon and Burgos in 2020. Two of these were diagnosed in men aged 90 and over, the other in a person who died of COVID-19.
In 2020, Spanish physicians urged that everyone tested for SARS-CoV-2 should also be tested for hepatitis B and C and subsequently recommended testing for viral hepatitis in all people vaccinated against SARS-CoV-2. These screening strategies were proposed in order to support progress towards hepatitis C elimination targets, since both modalities would reach large numbers of people who might otherwise have little contact with health services.
Spanish hospitals began testing people admitted with COVID-19 for hepatitis B and C in March 2020, following recommendations from the Spanish Ministry of Health. Patients were screened for hepatitis B antibodies and surface antigen and hepatitis C antibodies and RNA.
An analysis of COVID-19 admissions and viral hepatitis testing in Burgos and Leon found very low rates of chronic hepatitis B and C infection, perhaps because the median age of those admitted to hospital was 76 years.
In spite of these findings, researchers conclude that hepatitis B testing should be emphasised in people admitted to hospital with COVID-19, to minimise the risk of hepatitis B reactivation due to immunosuppressive treatments used to manage severe COVID-19.
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