217893 Viral hepatitis screening policies and practices in methadone maintenance centers

Monday, November 8, 2010 : 4:50 PM - 5:10 PM

Amy B. Jessop, PhD, MPH , Department of Health Policy & Public Health, University of the Sciences in Philadelphia, Philadelphia, PA
Amy Micheli, MPH , Division of Gastroenterology Research, University of Pennsylvania School of Medicine, Philadelphia, PA
Users of injected drugs (IDUs) are at high risk for hepatitis A exposure (66%) and chronic hepatitis B (6%), and hepatitis C (50-93%). Federal guidelines for medically-assisted treatment programs (MATs) include hepatitis screening.

In 2009 we interviewed directors from 10 of 12 Philadelphia-supported MATs (serving 3,700 of the 4,000 annual clients) to identify policies and practices for hepatitis-related testing and results communication.

Most policies mentioned HCV, 50% mentioned HBV and one mentioned HAV testing. Most considered timing and criteria for testing and half considered re-testing. Few policies mentioned results communication. Practices varied and frequently did not adhere to policy. Hepatitis tests occurred within one week of intake. All tested for anti-HCV antibodies. Sixty-percent tested for HBVsAg, 30% for anti-HBVsAb and none tested for anti-HAVAbs. Seventy-percent tested all clients, a few did risk-based testing or did not test transfer clients. Retesting was conducted in half of programs. A few re-tested all clients annually. Some retested upon request or under specific circumstances. Test results were communicated by staff with varied training and knowledge. One program could not identify who was responsible for communication and another communicated test results only if clients asked.

Inadequate policies and practices limit the ability of MATs to test appropriately, determine prevalence and vaccination needs, accurately inform clients of infection, and protect clients and communities from viral hepatitis. We propose recommendations to improve and reduce costs for hepatitis testing in MATs. Learning if you have a potentially life-threatening infection shouldn't depend on which MAT you enter.

Learning Areas:
Administer health education strategies, interventions and programs
Administration, management, leadership
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
Describe policies and processes for hepatitis screening in methadone maintenance. Identify means to improve hepatits screening and result communication in methadone maintenance.

Keywords: Hepatitis C, Methadone Maintenance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed, conducted, analyzed and prepared the report for the abstracts study. I am an experienced researcher in public health policies and infectious disease control practices.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.