Details:

Alternative Title:
BMC Infect Dis
Personal Author:
Southern, William N. ; Norton, Brianna ; Steinman, Meredith ; DeLuca, Joseph ; Drainoni, Mari-Lynn ; ... More +
Southern, William N. ; Norton, Brianna ; Steinman, Meredith ; DeLuca, Joseph ; Drainoni, Mari-Lynn ; Smith, Bryce D. ; Litwin, Alain H. Less -
Description:
Background

International guidelines and U.S. guidelines prior to 2012 only recommended testing for hepatitis C virus (HCV) infection among patients at risk, but adherence to guidelines is poor, and the majority of those infected remain undiagnosed. A strategy to perform one-time testing of all patients born during 1945–1965, birth cohort testing, may diagnose HCV infection among patients whose risk remains unknown. We sought to determine if a birth-cohort testing intervention for HCV antibody positivity helped identify patients with fewer documented risk factors or medical indications than a pre-intervention, risk-based testing strategy.

Methods

We used a cross-sectional design with retrospective electronic medical record review to examine patients identified with HCV antibody positivity (Ab+) during a pre-intervention (risk-based) phase, the standard of care at the time, vs. a birth-cohort testing intervention phase. We compared demographic and clinical characteristics and HCV risk-associated factors among patients whose HCV Ab + was identified during the pre-intervention (risk-based testing) vs. post birth-cohort intervention phases. Study subjects were patients identified as HCV-Ab + in the baseline (risk-based) and birth-cohort testing phases of the Hepatitis C Assessment and Testing (HepCAT) Project.

Results

Compared to the risk-based phase, patients newly diagnosed with HCV Ab + after the birth-cohort intervention were significantly less likely to have a history of any substance abuse (30.5 % vs. 49.5 %, p = 0.02), elevated alanine transaminase levels of > 40 U/L (22.0 % vs. 46.7 %, p = 0.002), or the composite any risk-associated factor (55.9 % vs. 79.0 %, p = 0.002).

Conclusions

Birth-cohort testing is an useful strategy for identifying previously undiagnosed HCV Ab + because it does not require providers ask risk-based questions, or patients to disclose risk behaviors, and appears to identify HCV Ab + in patients who would not have been identified using a risk-based testing strategy.


Subject:
[+]
Hepatitis C Virus
Research Article
Risk Assessment
Screening
Testing Strategies

Source:
BMC Infect Dis. 15.
Pubmed ID:
26626449
Pubmed Central ID:
PMC4667399
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:450c9d28852fb707858c84d35f0ca782e66fcde319440ececf6e35d031ec2d15
File Type:

Supporting Files

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