Opportunistic Screening for Hepatitis B and C in Primary Care Using a Reflex Testing System: A Microelimination Model.

Authors

Imma Valls, María Santos, Rosa Soriano, Montserrat Mullol, Ariadna Rando-Segura, Elena Vargas-Accarino, María Buti

Published in

Gastroenterologia y hepatologia. Pages 502839. Aug 08, 2026. Epub Aug 08, 2026.

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain a significant public health concern. Achieving the World Health Organization (WHO) elimination targets by 2030 requires more effective detection strategies than risk factor-based screening. This study evaluates an opportunistic screening program implemented in Primary Care, incorporating an automated diagnostic and referral pathway.
Prospective study of universal HBsAg and anti-HCV screening conducted in a Primary Care center in Barcelona. Adults requiring a blood test for any reason between February 2023 and February 2025 were included. Positive cases were directly referred to the Hepatology Department through an automated care pathway.
A total of 3,103 individuals were screened (41% male; mean age 51 years). The prevalence of anti-HCV positivity was 2.0%, with 0.35% having active infection; 82% of viremic patients initiated antiviral treatment. HBsAg prevalence was 0.8%, and 92% of referred cases attended specialist care; 17% initiated treatment. A higher number of risk factors was associated with anti-HCV positivity, whereas no predictors of HBsAg positivity were identified. Notably, 45% of patients with detectable HCV RNA and 44% of HBsAg-positive individuals had neither recognized risk factors nor elevated ALT levels.
Automated opportunistic screening in Primary Care is feasible and effective, identifying HBV and HCV infections that would likely remain undetected using risk factor-based screening strategies. This integrated approach may contribute substantially to the micro-elimination of viral hepatitis.

PMID:
42570758
Bibliographic data and abstract were imported from PubMed on 09 Aug 2026.

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