{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:45:04Z","timestamp":1791362704643,"version":"4.3.1"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,4,9]],"date-time":"2022-04-09T00:00:00Z","timestamp":1649462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Innovative testing approaches and care pathways are required to meet global hepatitis B virus (HBV) and hepatitis C virus (HCV) elimination goals. Routine blood\u2010borne virus (BBV) testing in emergency departments (EDs) in high\u2010prevalence areas is suggested by the European Centre for Disease Prevention and Control (ECDC) but there is limited evidence for this. Universal HIV testing in our ED according to UK guidance has been operational since 2015. We conducted a real\u2010world service evaluation of a modified electronic patient record (EPR) system to include opportunistic opt\u2010out HBV\/reflex\u2010HCV tests for any routine blood test orders for ED attendees aged \u226516\u00a0years. Reactive laboratory results were communicated directly to specialist clinical teams. Our model for contacting patients requiring linkage to care (new diagnoses\/known but disengaged) evolved from initially primarily hospital\u2010led to collaborating with regional health and community service networks. Over 11\u00a0months, 81,088 patients attended the ED; 36,865 (45.5%) had a blood test. Overall uptake for both HBV and HCV testing was 75%. Seroprevalence was 0.9% for hepatitis B surface antigen (HBsAg) and 0.9% for HCV antigen (HCV\u2010Ag). 79% of 140\u00a0successfully contacted HBsAg+patients required linkage to care, of which 87% engaged. 76% of 130 contactable HCV\u2010Ag+patients required linkage, 52% engaged. Our results demonstrate effectiveness and sustainability of universal ED EPR opt\u2010out HBV\/HCV testing combined with comprehensive linkage to care pathways, allowing care provision particularly for marginalized at\u2010risk groups with limited healthcare access. The findings support the ECDC BBV testing guidance and may inform future UK hepatitis testing guidance.<\/jats:p>","DOI":"10.1111\/jvh.13676","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T11:54:16Z","timestamp":1648727656000},"page":"559-568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["VirA+EmiC project: Evaluating real\u2010world effectiveness and sustainability of integrated routine opportunistic hepatitis B and C testing in a large urban emergency department"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7524-1947","authenticated-orcid":false,"given":"Gaia","family":"Nebbia","sequence":"first","affiliation":[{"name":"Department of Infection Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murad","family":"Ruf","sequence":"additional","affiliation":[{"name":"Gilead Sciences Ltd UK &amp; Ireland Medical Department  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Hunter","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sooria","family":"Balasegaram","sequence":"additional","affiliation":[{"name":"Field Epidemiology Service National Infection Service UK Health Security Agency, London UK  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Wong","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjababu","family":"Kulasegaram","sequence":"additional","affiliation":[{"name":"Department of HIV\/GU Medicine Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Surey","sequence":"additional","affiliation":[{"name":"Institute for Global Health University College London  London UK"},{"name":"Universidad Aut\u00f3noma de Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zana","family":"Khan","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Health Care UCL and South London and Maudsley Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1331-387X","authenticated-orcid":false,"given":"Jack","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basel","family":"Karo","sequence":"additional","affiliation":[{"name":"International Health Protection (ZIG 1) Robert Koch Institute (RKI)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Snell","sequence":"additional","affiliation":[{"name":"Department of Infection Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barnaby","family":"Flower","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Evans","sequence":"additional","affiliation":[{"name":"Field Epidemiology Service National Infection Service UK Health Security Agency, London UK  London UK"},{"name":"UK Field Epidemiology Training Programme UK Health Security Agency  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Douthwaite","sequence":"additional","affiliation":[{"name":"Department of Infection Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,9]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Public Health England.Hepatitis C in the UK 2020: Working to eliminate hepatitis C as a major public health threat. 2020.https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/943154\/HCV_in_the_UK_2020.pdfAccessed 30 July 2021"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(18)30056-6"},{"key":"e_1_2_10_4_1","unstructured":"National Institute for Health and Care Excellence.Sofosbuvir\u2013velpatasvir for treating chronic hepatitis C. 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NICE guideline [NG60].2016.https:\/\/www.nice.org.uk\/guidance\/ng60Accessed 30 July 2021"},{"key":"e_1_2_10_17_1","unstructured":"NICE.Hepatitis B and C testing: people at risk of infection.2013.https:\/\/www.nice.org.uk\/guidance\/ph43\/resources\/hepatitis\u2010b\u2010and\u2010c\u2010testing\u2010people\u2010at\u2010risk\u2010of\u2010infection\u20101996356260293Accessed 30 July 2021"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12364"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268818000870"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12590"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2019-208637"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198520"},{"key":"e_1_2_10_23_1","unstructured":"HunterL LarbalestierN PaparelloJ.Routine HIV testing in an inner city emergency department \u2013 avoiding missed opportunities for testing. 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