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Undiagnosed HCV more common than HIV in recent survey

Undiagnosed hepatitis C was more common than undiagnosed HIV in a survey of patients admitted to a New York emergency department, according to a recently published study.

Lucia V. Torian, PhD, from the New York City Department of Health and Mental Hygiene, and colleagues, advised that aggressive testing initiatives similar to those directed toward HIV should be implemented to improve HCV diagnosis.

“Linkage to HCV care may require dedicated resources, at least until the anticipated bolus of previously undiagnosed cases is diagnosed, linked, and treated,” Torian and colleagues wrote. “Lessons from HIV are both instructive and sobering: routine HIV screening is not truly routine; linkage continues to challenge even experienced providers; and linkage and treatment initiation vary widely across sites.”

The researchers conducted a survey of adults admitted in 2015 to an emergency department in the Bronx, New York City, which had more than 125,000 visits that year. The researchers noted that the Bronx is the poorest urban county in the United states and has the highest rate of unemployment and proportion of deaths attributable to accidental overdose in the city.

Of the 10,357 patients who visited the department during the survey and had blood drawn, 75.7% were in the age range recommended by New York state for HIV testing (range, 13-64 years) and 38.2% were born between 1945 and 1965, the birth range in which the CDC recommends HCV testing.

The overall prevalence of HIV was 5%, which was higher among men (7.2%) than women (3.7%). The prevalence of undiagnosed HIV was 0.2% and the proportion of undiagnosed HIV was 4.8%.

In comparison, the overall prevalence of HCV was 3.9% and the prevalence of undiagnosed HCV was 0.8%. Undiagnosed HCV was more common among men (1.2%) than women (0.5%) and the researchers observed the highest rates among patients born between 1929 and 1944 (1.2%) and those born between 1945 and 1965 (1.2%).

“[Emergency departments] may serve populations not presenting to other health care settings, including those with acute HIV infection,” the researchers wrote. “These findings argue in favor of an HCV testing initiative similar to that introduced by New York State to combat HIV with its 2010 testing and linkage to care legislation, Department of Health HIV testing initiatives, and 2014 End the Epidemic campaign, and without age restriction.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.