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Targeted HCV screening effectively identified infected former drug users

A hepatitis C screening program targeted toward former injection drug users was effective in identifying infected participants in a recent study.

Researchers evaluated the results of the New Life New Liver Project, a program offering targeted HCV screening and education for former injection drug users (IDUs) in Hong Kong. The study included 234 adults between 2009 and 2012, 56% of whom tested positive for anti-HCV and were invited to a follow-up visit for evaluation.

At follow-up, participants’ HCV genotype and viral load were measured, along with liver biochemistry, and HIV serology and the presence of HBV surface antigen were determined. Liver stiffness measurement via transient elastography also was performed. Patients were referred to regional hospitals for additional follow-up and any necessary treatment.

The number-needed-to-screen in order to detect one case of anti-HCV positivity was calculated as 1.8 (95% CI, 1.6-2). Of the 130 anti-HCV positive participants, 111 underwent initial follow-up. Within this subgroup, 88% had detectable HCV RNA, 26% had liver stiffness measurements indicating significant fibrosis, and 14% had measurements indicating cirrhosis. Patients attended additional follow-up in 69 cases, and 26 of these patients received antiviral therapy.

Patients who had follow-up were older (P=.022), with a higher level of education (34.8% with secondary school or higher vs. 16.7%; P=.039), and more frequently presented with detectable HCV RNA (97.1% of cases vs. 73.8%; P<.001). Follow-up patients also had higher ALT (65 IU/L compared with 32 IU/L; P<.001) and HCV RNA levels (5.8 log IU/mL vs. 4.1 log IU/mL; P=.001)and greater liver stiffness (6.2 kPa vs. 5.3 kPa; P=.02) than those who did not attend.

Vincent Wai-Sun Wong

“Active targeted hepatitis C screening in ex-injection drug users is worthwhile and effective,” Vincent Wai-Sun Wong, MD, professor in the department of medicine and therapeutics at the Chinese University of Hong Kong, told Healio.com. “In the era of effective hepatitis C treatment, clinicians should take the lead to increase treatment uptake and help underprivileged groups.”

Disclosure: See the study for a full list of relevant financial disclosures.