The Camden and Islington Viral Hepatitis Identification Tool (CIVHIT): Use of a Clinical Database Case‐Finding Tool for Hepatitis B, Hepatitis C and HIV in Primary Care

TL;DR

A computer tool called CIVHIT helped identify more people at risk for hepatitis and HIV in primary care, leading to increased testing and diagnoses.

Contribution

CIVHIT is a novel clinical database tool that effectively increased BBV testing and diagnosis rates in primary care settings.

Findings

CIVHIT increased BBV tests by 78.5% and new diagnoses by 55.8% in primary care.

HBV testing saw the largest increase, with twice as many people diagnosed compared to before.

Individuals with drug use or hepatitis contacts were more likely to be tested than those flagged for STI history.

Abstract

Despite the availability of effective treatment and vaccines for hepatitis B virus (HBV) and C virus (HCV), many people are still infected and remain unaware of their infection. The Camden and Islington Viral Hepatitis Identification Tool (CIVHIT), a computer‐based search tool, was introduced in 60 general practices (GPs) in April 2014 to support identification, testing and treatment of individuals at high risk for blood‐borne viruses (BBVs). CIVHIT searched electronic medical records (EMRs), flagging all those with codes linked to risk factors or medical conditions associated with BBVs. CIVHIT was associated with a 78.5% increase in BBV tests in primary care in both boroughs. This translated to a 55.8% rise in new diagnoses. HBV testing saw the largest increase resulting in twice as many people diagnosed. Only 23.2% of HBV and 14.9% of HCV‐positive tests were referred to secondary care. In an index practice, the most common flag was a history of STIs (477/719, 66.3%). Individuals with previous or current drug use and those with a known hepatitis contact were more likely to be offered a test compared to those flagged due to a history of STI. HIV and HBV testing was lower in males following a test offer. There was an increased likelihood of testing for HBV and HCV with increasing age. Additionally, individuals with previous or current drug use and individuals with a known hepatitis contact were more likely to test for HCV compared to individuals flagged due to STI history. CIVHIT shows promise to assist with the elimination of BBVs.

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