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Presence of HCV symptoms reason for testing in almost half of infected patients
Nearly half of adults infected with hepatitis C sought testing only after experiencing the clinical indications of liver disease, according to the CDC.
“Physicians should test all baby boomers for HCV infection, while using risk-based screening for all others,” US Public Health Service Lt. Cmdr. Stephen C. Ko, MD, MPH, a CDC epidemic intelligence service officer, told Infectious Disease News.
Stephen C. Ko
Ko and colleagues collected data from a survey of 4,689 adults aged at least 18 years with confirmed chronic HCV or hepatitis B infection who reported on their reasons for seeking HCV testing and the location of the tests.
According to the researchers, 60.4% of respondents said their initial HCV test occurred in a physician's office. Only 22.3% of HCV patients cited injection drug use and hemodialysis — two risk factors included in the CDC's 1998 guidelines for HCV testing — as reasons for getting tested, whereas 45.2% cited clinical indications such abnormal liver function tests or liver-related symptoms as reasons for testing.
According to some studies, up to half of all individuals infected with HCV in the United States are unaware of their infection status. In 2012, the CDC recommended one-time testing for all persons born between 1945 and 1965, as they are at higher risk for infection.
Almost 80% of respondents in the survey belonged to this age group. Of those, 21.3% cited CDC risk indications as reasons for getting tested, whereas 46.8% said clinical indications of their infection had prompted testing.
"CDC is identifying strategies to help health care providers implement its new HCV testing guidelines, which target all persons born during 1945-1965," the researchers wrote. "These strategies include simplification of HCV testing algorithms in primary care and public health settings, development of national educational strategies for testing those born during 1945-1965, and supporting evidence-based care models that enhance delivery of high-quality HCV assessment and management."
Stephen Ko, MD, MPH, can be reached at 1600 Clifton Road, NE/MS G-37, Atlanta, GA 30333; email: stephenko@cdc.gov.
Disclosure: The researchers report no relevant financial disclosures.