High hepatitis C infection rate among baby boomers in an urban primary care clinic: Results from the HepTLC initiative

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High hepatitis C infection rate among baby boomers in an urban primary care clinic: Results from the HepTLC initiative

Authors

Geboy, A. G.,Mahajan, S.,Daly, A. P.,Sewell, C. F.,Fleming, I. C.,Cha, H. A.,Perez, I. E.,Cole, C. A.,Ayodele, A. A.,Fishbein, D. A.

Citation
2016
Public Health Reports

131

Supplement 2
49-56
Type
Prospective cohort
Virus targets
Hepatitis C
Interventions
HCV testing and linkage to Care
Linkage to care
Screening and diagnosis
Testing
Setting
National
Target populations
General Population
Country of development
United States of America
Target location
United States of America
DOI
10.1177/00333549161310S209
Testing strategy
Point-of-care antibody test (rapid test)
Laboratory-based antibody test
Laboratory-based PCR/RNA (confirmatory) test
Point-of-care antibody test (rapid test), Laboratory-based PCR/RNA (confirmatory) test
Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test
Countries of included studies
United States of America

Health outcomes

Number new diagnoses,Linkage to care

Testing strategy

Point-of-care antibody test (rapid test), Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test

Abstract

Objective. CDC recommends that all people born between 1945 and 1965 be tested for hepatitis C virus (HCV). We hypothesized that HCV testing in a large, urban primary care clinic would reveal higher rates of HCV infection than previously published. Methods. Through the Hepatitis Testing and Linkage to Care initiative, the primary care clinic at MedStar Washington Hospital Center in Washington, DC, provided HCV antibody (anti-HCV) testing and linkage to care from October 2012 through September 2013 for patients born between 1945 and 1965 without previously noted risk factors. We collected data on age, race/ethnicity, sex, anti-HCV and HCV ribonucleic acid (RNA) results, risk factors in those who tested anti-HCV positive, and health insurance type and made comparisons using chi<sup>2</sup> and Student's t-tests. Results. Of 1,123 patients tested, the mean age was 57 years, 742 (66.1%) were women, 969 (86.3%) were black/African American, and 654 (58.2%) had public health insurance. Of the 99 (8.8%) patients who tested anti-HCV positive, the mean age was 58 years, 54 were men, and 93 were black/African American; 41 of 74 anti-HCV-positive patients were intravenous drug users. Of 82 anti-HCV-positive patients, 51 were HCV RNA positive. Of the black/ African American patients tested, 49 of 317 men (15.5%) and 44 of 652 women (6.7%) were anti-HCV positive (p<0.001). The HCV prevalence rate in the birth cohort (8.8%) was significantly higher than the U.S. (3.3%) and DC (2.5%) rates (p<0.001), and the HCV prevalence rate among black/African American men in DC (15.5%) was substantially higher than the prevalence rate reported by CDC (8.1%). Conclusion. Testing initiatives in primary care settings need to be more rigorously upheld, and internal champions are needed to advocate for increased screening to ensure linkage to care and engagement in the HCV care cascade. Copyright © 2016 Association of Schools and Programs of Public Health.

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22 Jan 2021