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Birth cohort alone insufficient as HCV screening criterion
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SAN DIEGO — Screening for hepatitis C according to age alone was not as effective in detecting infection as risk-based screening in a study presented at the American College of Gastroenterology Annual Scientific Meeting.
Researchers administered a questionnaire about HCV risk factors to 396 patients at two community hospitals in New York and performed HCV screening in 160 patients aged 40 to 74 years within this population who had never been tested previously. The cohort also included 45 patients who wanted but did not receive HCV screening, 34 who refused screening, 157 with known HCV antibody status, and 85 who had previously tested positive for HCV. Of screened patients, 64.9% were African-American and approximately 23.7% were Hispanic. Seventy-six percent had a high school-level education or lower.
Among the 160 patients who underwent screening during the study, only one tested positive, and investigators said this patient had a HCV risk factor (multiple sexual partners). Nearly all HCV-positive patients across the cohort were aged 48 to 68 years, but all those with HCV also had one or more risk factors for the illness. Approximately half of patients screened (50.9%) tested negative for HCV and had no known risk factors, while 1.1% of those with HCV tested positive without risk factors.
“Age alone didn’t prove to be a criterion for diagnosis,” researcher Ayotokunbo Olosunde, MD, GI fellow at Interfaith Medical Center in New York, told Healio.com. “It was a small study, but it shows that for us to get that one [HCV-positive] patient, we have to do a lot of testing. [Birth-cohort screening] is a recommendation, but you have to be prepared for a lot of negative tests before you find that one patient who will be positive. We can’t throw away risk-based screening … we have to do it in combination.”
“[Birth-cohort screening] doesn’t take away the previous guidelines that we had in 1998, that people with risk factors have to be screened,” Gopal Kaza, MD, Interfaith Medical Center, said. “That takes precedence over age-based screening. If someone has risk factors, you screen them. The chance of us getting a positive value is higher than just saying, ‘You were born between 1945 and 1965, let me do HCV testing.’ ”
Disclosure: The researchers report no relevant financial disclosures.
For more information:
Olosunde A. P228: Effectiveness of Birth Cohort Screening for Hepatitis C: An Inner-City Experience. Presented at: the 2013 American College of Gastroenterology Annual Scientific Meeting; Oct. 11-16, San Diego.