According to researchers, more than 6% of baby boomers tested positive for hepatitis C virus antibodies during a recent 7-month period at a small-city New Jersey ED — twice as high as the CDC estimate for the high-risk group.
Baby boomers born between 1945 and 1965 account for approximately 81% of all patients living with chronic HCV, according to Julia K. Cornett, MD, infectious disease physician in the Rutgers Robert Wood Johnson Medical School department of medicine, and colleagues. Since 2013, the United States Preventive Services Task Force has recommended one-time HCV screening for these patients, but testing rates remain low, indicating that national guidelines have had only a minimal impact, Cornett and colleagues said.
The researchers conducted a retrospective cohort study using results from an opt-out HCV screening that targeted baby boomers in a large ED that draws socioeconomically diverse patients from the small New Jersey city where it is located and the surrounding suburbs. They found a high prevalence of HCV in study participants, but also a lower-than-expected overall rate of positive HCV viral load.
Writing in Open Forum Infectious Diseases, Cornett and colleagues said their project was unlike past HCV screening studies conducted in urban EDs.
“We believe our study to be the first report of data from an HCV screening program in a small urban/suburban ED with demographics unlike those of previous studies in large urban EDs,” they wrote. “Results from our study can be used to advocate for the expansion of routine screening programs of the baby-boomer cohort in diverse ED settings not limited to HCV epicenters in large urban settings.”
Among 2,928 patients screened in the ED from June through December 2016, 6.6% tested positive for HCV antibodies, Cornett and colleagues reported. Of the 167 patients with HCV viral load testing results, 43% had a positive viral load — in contrast to past studies that have reported rates of chronic HCV between 70% and 87%, Cornett and colleagues said.
“While this study was a descriptive analysis rather than a true seroprevalence study, our findings support the argument that ED screening for HCV is important in a variety of settings,” they wrote. “But as the authors of a recent HCV screening study noted, HCV infection may be perceived as an epidemic limited to epicenters, rather than as a nationwide health problem. Previously noted studies assessing HCV testing in EDs were all conducted in large urban epicenters such as Baltimore and New York City. Our study serves as the first report from an ED setting not located in a large urban location and may be considered more generalizable to other smaller U.S. urban/suburban settings. – by Gerard Gallagher
Disclosure: Cornett reports receiving a service grant from Gilead Sciences paid to Rutgers.