Cabezas Joaquin, Aguilera Antonio, García Federico, Domínguez-Hernández Raquel, Casado-Gómez Araceli, Espinoza-Cámac Nataly, Casado Miguel Ángel, Crespo Javier
Gastroenterology and Hepatology Service, Marqués de Valdecilla University Hospital, 39008 Santander, Spain.
Clinical and Translational Research Group in Digestive Diseases, Valdecilla Research Institute (IDIVAL), 39011 Santander, Spain.
Viruses. 2025 May 3;17(5):667. doi: 10.3390/v17050667.
In 2022, scientific societies agreed on a document with recommendations for a comprehensive diagnosis of viral hepatitis (B, C, and D). The aim was to evaluate the situation in Spain regarding the comprehensive diagnosis of viral hepatitis in a single blood draw before it is recommended. A panel of experts prepared a structured survey directed at hospitals (public or private with teaching accreditation) with ≥200 beds (sent 20 October 2022, closed 1 December 2022). The response rate was 61% (79/129; 52 hospitals with >500 beds). Among the participating hospitals, all could perform tests for HBsAg, anti-HCV, and HIV serology; 94% could perform PCR testing for HCV, 63% could test for anti-HDV, and 28% could test for HDV-RNA (67% [53/79] outsourced this testing). Point-of-care (POC) testing availability was low (24%), with 84% of these tests being supervised by the reference microbiological laboratory and the results being registered in the patients' medical history. Ninety percent of the centers carried out the diagnosis in a single step (99% HCV, 70% HBV, 48% HDV, and 44% HBV-HDV). In addition, 77% used some communication strategy when an active infection was encountered (100% HCV, 49% HBV, and 31% HDV). Only 20% had an automated system for scheduling a specialist physician appointment. Most hospitals had the means for a comprehensive diagnosis of viral hepatitis in a single sample, but <50% could test for HBV/HDV. Alerts for continuity of care were available for HCV, but not HBV or HDV. POC device implementation is important for decentralized testing.
2022年，多个科学协会就一份关于病毒性肝炎（乙型、丙型和丁型）综合诊断建议的文件达成了一致。目的是在建议进行一次采血全面诊断病毒性肝炎之前，评估西班牙的相关情况。一个专家小组针对拥有≥200张床位的医院（公立或具有教学资质的私立医院）编制了一份结构化调查问卷（于2022年10月20日发送，2022年12月1日截止）。回复率为61%（79/129；52家床位>500张的医院）。在参与调查的医院中，所有医院都能进行乙肝表面抗原、抗丙肝病毒和艾滋病毒血清学检测；94%的医院能进行丙肝病毒的聚合酶链反应检测，63%的医院能检测抗丁肝病毒，28%的医院能检测丁肝病毒核糖核酸（其中67%[53/79]将此项检测外包）。即时检测（POC）的可用性较低（24%），这些检测中有84%由参考微生物实验室监督，结果记录在患者病历中。90%的中心采用单步诊断（丙肝99%、乙肝70%、丁肝48%、乙肝-丁肝44%）。此外，77%的医院在发现活动性感染时会采用某种沟通策略（丙肝100%、乙肝49%、丁肝31%）。只有20%的医院有自动预约专科医生的系统。大多数医院具备对单个样本进行病毒性肝炎综合诊断的手段，但不到50%的医院能检测乙肝/丁肝。丙肝有连续护理警报，但乙肝或丁肝没有。即时检测设备的实施对分散检测很重要。
