title: Need for improvements in the surveillance and management of chronic viral hepatitis in HIV patients followed in a Danish outpatient clinic.
abstract: OBJECTIVE
  The aim of this study was to assess hepatitis B virus (HBV) and hepatitis C virus (HCV) surveillance and management in HIV patients currently followed in an outpatient clinic at a Danish University Hospital.
  
  
  METHODS
  Patient data, including demographic characteristics, clinical findings, and hepatitis serology, were reviewed at baseline. Patients with incomplete or non-updated serology within the last 2 y were retested in the next 6 months, and the results were reviewed again at follow-up.
  
  
  RESULTS
  At baseline, 84% and 74% of the 574 HIV patients were found to have incomplete and/or non-updated HBV and HCV serology, respectively. At follow-up, updated HBV serology was achieved in 535 (93%) patients; 15 (3%) patients were found to have a chronic active infection and 156 (27%) had a resolved infection, whereas 65 (11%) were vaccinated against HBV and 299 (52%) were non-immune. No patients were found to have developed chronic HBV infection following HIV diagnosis (equal to 3649 patient-y). Updated HCV serology revealed that 25 (4%) had a chronic active HCV infection and 15 (3%) had a resolved HCV infection. The anti-HCV incidence rate was 0.27/100 patient-y. A liver pathology assessment had not been performed within the last 2 y in 80% of the HBV and 32% of the HCV co-infected patients.
  
  
  CONCLUSIONS
  Hepatitis screening and assessment had been inadequately performed. New cases of chronic hepatitis seem to occur infrequently. However, a more proactive hepatitis surveillance and management strategy integrated into the overall HIV health care program is warranted.
authors.affiliation: From the Department of Infectious Diseases, Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Karen Lise Dahl
authors.initials: KL
authors.lastname: Andersen
authors.forename: Carsten Schade
authors.initials: CS
authors.lastname: Larsen
authors.forename: Mikkel Steen
authors.initials: MS
authors.lastname: Petersen
authors.forename: Peter Derek Christian
authors.initials: PD
authors.lastname: Leutscher
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D019090:Case Management; D003718:Denmark; D062665:Epidemiological Monitoring; D005260:Female; D015658:HIV Infections / Q000150:complications; D006302:Health Services Research; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000628:therapy*; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: HIV; screening; seroprevalence; vaccination; viral hepatitis