An opt-out hepatitis C virus (HCV) screening program at a Boston emergency department proved an effective means of identifying cases of the virus among people whose demographics would not normally have led clinicians to test them.
Publishing their findings in Academic Emergency Medicine, researchers at Boston Medical Center stepped up their HCV testing starting November 2016 and also provided linkage to care for the virus to those who tested positive. To receive testing, patients had to be 13 years old or older and receiving blood testing for other purposes and give authorization for hep C testing.
Analyzing data from November 2016 to January 2017, the study authors found that the hospital’s emergency department tested 3,808 people for HCV, for an average of 1,269 tests per month. This reflected a 70-fold increase compared with an average of 18 tests per month during 2015 to 2016.
A total of 504 (13 percent) of the initial HCV antibody tests were positive. A total of 493 (97 percent) of those individuals had an RNA test conducted to confirm whether they had a chronic hep C infection, which was the case for 292 people. This meant that 7.7 percent of those tested for the virus had chronic hep C.
Of those who tested positive for chronic HCV, 155 (53 percent) were born outside of 1945 to 1965 (meaning they were not baby boomers), the birth cohort for whom the Centers for Disease Control and Prevention (CDC) recommends a routine one-time hep C test. Forty-six (15.8 percent) of those with chronic hep C were non–baby boomers who did not report injection drug use.
The hospital made attempts to link 223 (76.4 percent) of those with chronic hep C to medical care for the virus, with 102 (38 percent of those with attempted linkage) of these individuals scheduling appointments for such care. Sixty-six people attended their first visit for HCV care (22.5 percent of all those with chronic HCV and 30 percent of those who were eligible to receive the linkage-to-care services).
To read a press release about the study, click here.
To read the study abstract, click here.