The Rate of Referral of Hepatitis Virus Carriers to Hepatologists and the Factors Contributing to Referral

作者：Takata Kazuhide^*; Anan Akira; Morihara Daisuke; Yotsumoto Kaoru; Sakurai Kunitoshi; Fukunaga Atsushi; Tanaka Takashi; Yokoyama Keiji; Takeyama Yasuaki; Irie Makoto; Shakado Satoshi; Sohda Tetsuro; Sakisaka Shotaro

来源：Internal Medicine, 2017, 56(15): 1943-1948.

DOI：10.2169/internalmedicine.56.8249

• hepatitis virus carriers
• medical collaboration
• non-hepatologist
• HBV
• HCV

Objective The aims of the present study were to determine the proportions of hepatitis B surface antigen (HBsAg)-positive and anti-hepatitis C virus (HCV)-positive patients, and identify the characteristics that influenced referral to a hepatologist.
Methods The present study included patients who were positive for HBsAg (n=153) or anti-HCV (n=574); their viral status was tested by non-hepatologists between January 2008 to December 2012. We performed a multivariate analysis to investigate the factors associated with the referral of patients to hepatologists.
Results The rates of hepatitis B virus (HBV) and the percentage of suspected HCV carriers at the hospital were 1.4% and 3.5%, respectively. Among the 727 patients who were seropositive for HBV or HCV, 107 (14.7%) were referred to a hepatologist. A multivariate analysis to investigate the factors contributing to referral revealed that (i) an alanine aminotransferase (ALT) level of >30 IU/L [ odds ratio (OR), 3.24; 95% confidence interval (CI), 2.10-5.03; p<0.001]; (ii) undergoing testing at an internal medicine department (OR, 2.79; 95% CI, 1.80-4.38; p<0.001); and (iii) HBsAg-positivity (OR, 2.22; 95% CI, 1.35-3.61; p=0.002) were factors that significantly influenced referral.
Conclusion Hepatologists must educate non-hepatologists, especially non-internists, to promote the referral of hepatitis-virus carriers, especially HCV carriers, even in patients with ALT levels of <30 IU/L.

• 出版日期2017