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Outpatient Endoscopy Offers Additional Chance for HCV Screening

Most patients who received an offer for hepatitis C screening during outpatient endoscopy accepted and completed the test the same day or same week, according to recently published results.

Robert Wong, MD, MS

“Despite increased awareness of HCV screening, overall HCV screening rates remain low, particularly among underserved safety-net populations, a group that is particularly vulnerable to disparities in medical care,” Robert Wong, MD, MS, told Healio.com/Hepatology. “Developing novel ideas to further improve HCV screening and linkage to care are needed, and incorporating HCV screening into outpatient endoscopy units may provide a feasible option to achieve improved screening rates.”

From July 1, 2015, to July 1, 2016, the researchers evaluated 1,125 patients who presented for outpatient endoscopy at an urban safety-net hospital. Mean patient age was 52.4 years and 59.7% were born between 1945 and 1965, considered the baby boomer generation.

“HCV screening in an outpatient endoscopy setting presents an opportunity for HCV screening, given that most patients referred for screening colonoscopy fall within the 1945-1965 birth cohort for which HCV testing is recommended,” Wong and colleagues wrote.

Of the 748 patients eligible for HCV screening, 502 accepted testing and 318 completed the test. Most completed the test the same day (81.1%) or at least within 1 week (94.7%) with no significant difference between birth year or risk factors.

Fourteen patients had positive HCV antibodies. Eleven of those patients completed confirmatory testing. The researchers then linked the six patients with confirmed HCV to care.

“While our results are encouraging among safety-net populations, they may not be completely generalizable to more vulnerable populations with significant barriers in access to care,” Wong and colleagues wrote.

As direct-acting antivirals present the potential for a global HCV cure, screening and testing, especially among higher risk and harder-to-reach populations, is ever more important. Healio.com has recently reported on HCV screening among baby boomers, HIV coinfected patients, Native Americans, and women of reproductive age:

New York mandate increases HCV screening among baby boomers

Hepatitis C testing among baby boomers increased more than 50% in New York, following the implementation of a testing law in 2014 that required health care providers to offer HCV screening to all patients born between 1945 to 1965, according to a report from the CDC. Read more

‘Tweak’ in order set increases HCV screening among patients with HIV

Adding hepatitis C virus screening to an automated order set for patients with HIV greatly increased hepatitis testing at a Massachusetts clinic, according to researchers. Read more

New EHR alert increases HCV screening among baby boomers

Implementation of an electronic health record-based prompt significantly increased hepatitis C screening rates among baby boomers in primary care. According to the researchers, HCV screening among adults born between 1945 and 1965 increased fivefold during a 1-year period following implementation of the Best Practice Advisory (BPA) EHR alert. Read more

Universal screening in Cherokee Nation aims to eliminate hepatitis C

Nearly half of the Cherokee Nation American Indian population received screening for hepatitis C and approximately one-quarter of those with the infection are cured, according to a press release from the World Indigenous People’s Conference on Viral Hepatitis in Anchorage, Alaska, which coincides with the International Day of the World’s Indigenous Peoples on Aug. 9. Read more

Rise of HCV among reproductive-age women suggests need for screening

A recent substantial increase in hepatitis C virus infection among reproduction-aged women in the United States highlights a need for routine HCV screening during pregnancy, according to recent data published in Annals Internal Medicine. Read more

Disclosure: Campbell reports no relevant financial disclosures. Please see the full study for the other authors’ relevant financial disclosures.