Establishing a program of providing blanket opt-out hepatitis C virus (HCV) testing in hospital emergency departments is an effective means of detecting the virus, especially among those younger than 55 years old, according to a new Centers for Disease Control and Prevention (CDC) analysis.
Publishing their findings in the Morbidity and Mortality Weekly Report, the CDC researchers conducted a retrospective study of four urban academic emergency departments located in Birmingham, Alabama; Oakland, California; Boston; and Baltimore.
Each department implemented a universal opt-out hep C testing program. The analysis looked at a four-month period beginning one month after the implementation of the testing program, except for the Baltimore program, which provided three months of data.
The emergency departments performed tests on 14,252 individuals, among whom 1,135 (9.2%) tested positive for HCV antibodies (which indicate that an individual has ever been infected with hep C). A total of 1,118 (85%) of these individuals then received RNA testing for HCV, among whom 693 (62%) tested positive and therefore currently had the virus.
Among the baby boomers, meaning those born between 1945 and 1965, 13.9% of those tested were positive for HCV antibodies, including 16.0% of Blacks and 12.2% of whites; 18.9% of men and 8.7% of women; and 17.7% of those with public insurance such as Medicaid, 13.6 % of those with Medicare and 8.4% of those with private insurance.
Among those born after 1965, 6.7% of those who received testing were positive for HCV antibodies, including 3.2% of Blacks and 15.3% of whites; 8.3% of men and 5.1% of women; 8.6% of those with public insurance such as Medicaid, 9.0% of those with Medicare and 3.0% of those with private insurance.
A total of 628 (47.8%) of the 1,315 positive antibody tests were among those born after 1965.
“Opt-out universal screening in EDs can identify a larger number of previously unrecognized HCV infections, especially among persons born after 1965,” the study authors concluded. “ED-based opt-out universal hepatitis C screening can be vital in combating and surveilling the interrelated epidemics of opioid overdose and blood-borne viral infections through harm-reduction interventions and navigation to HCV treatment.
In light of the increasing proportion of hep C cases among younger adults, public health officials now recommend routine HCV testing for all adults regardless of age or risk factors.
To read the CDC report, click here.