Management of Hepatitis B Surface Antigen and Hepatitis C Antibody-Positive Patients by Departments Not Specializing in Hepatology at a Suburban University Hospital in Japan: A Single-Center Observational Study
Received 24 June 2020
Accepted for publication 27 August 2020
Published 1 October 2020 Volume 2020:13 Pages 743—750
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Yoshinori Tokushima,1,* Masaki Tago,1,* Midori Tokushima,1 Naoko E Katsuki,1 Shinji Iwane,2 Yuichiro Eguchi,3 Shu-ichi Yamashita1
1Department of General Medicine, Saga University Hospital, Saga, Japan; 2Fujioka Hospital, Saga, Japan; 3Eguchi Hospital, Saga, Japan
*These authors contributed equally to this work
Correspondence: Masaki Tago
Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga 849-8501, Japan
Tel +81 952 34 3238
Fax +81 952 34 2029
Objective: To investigate effects of an altered medical environment between 2010 and 2015 on viral hepatitis treatment behaviors of doctors who were not hepatology specialists.
Methods: Charts of patients who were identified as hepatitis B surface antigen (HBs-Ag)-positive or hepatitis C virus antibody (HCV-Ab)-positive by university hospital departments not specializing in hepatology from January to December 2015 were retrospectively reviewed. Patients were assigned to a “referred” group or a “non-referred” group based on whether they were subsequently referred to the Hepatology Department. Age, sex, type of department visited (one of various internal medicine departments, or a different department), and blood test results were compared in the two groups.
Results: Among 7,824 patients screened for HBs-Ag, 82 were positive. Twenty-nine (35.4%) had subsequently been referred to the Hepatology Department, which was higher than the 2010 referral rate (20.6%). In multivariate analysis, patients in the referred group were significantly more likely to have visited one of various internal medicine departments, and they had higher levels of platelet count and γ-glutamyl transpeptidase. Among 7,778 patients screened for HCV-Ab, 279 were positive. Only 33 (11.8%) had subsequently been referred to the Hepatology Department, which was lower than the 2010 referral rate (18.7%). In multivariate analysis, patients in the referred group were significantly more likely to have visited an internal medicine department.
Conclusion: HCV-antibody-positive patients screened by departments not specializing in hepatology were not managed adequately in 2015. This suggests a need for education of doctors not specializing in hepatology, particularly those not working in internal medicine departments.
Keywords: hepatitis B virus, hepatitis C virus, hepatitis B, hepatitis C, referral, department
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