Antibody testing in STD clinic identified high prevalence of HCV

Issue: November 2014

PHILADELPHIA — Researchers found a high prevalence of hepatitis C virus infection among individuals screened for the virus while attending an urban STD clinic, according to study data presented at IDWeek 2014.

“Despite patient navigation services for those testing positive, there was low attendance at offsite HCV specialist appointments,” Oluwaseun Falade-Nwulia, MD, MPH, of the Baltimore City Health Department and Johns Hopkins University School of Medicine, said during her presentation. “Patients who did not follow up with HCV specialists continue to access the STD clinics for care.”

Falade-Nwulia and colleagues evaluated the HCV testing and linkage to a care program funded by the CDC Foundation/Viral Hepatitis Action Coalition at the Baltimore City Health Department STD clinics starting in June 2013. Patients aged 18 to 70 years who attended the clinics were offered HCV antibody testing and if positive, follow-up HCV RNA testing was provided. When patients returned for RNA test results, they also received initial comprehensive HCV care and referral for specialist HCV treatment.

From June 24, 2013 to April 15, 2014, HCV antibody tests were offered to 4,399 unique clients, among whom 2,682 HCV antibody tests were performed. Of the tests performed, 189 (7%) were HCV antibody positive and among those, 155 were HCV RNA positive. The prevalence of HCV reactivity was 83% among people who ever injected drugs, 77% among current injection drug users and 29% among baby boomers.

Through Aug. 15, 2014, 154 of the patients are aware of their infection, 138 received an initial HCV evaluation at the STD Clinic, and 132 were referred to a specialist for HCV care. Ninety-six of those patients attended the specialist appointment. Among those who did not attend the appointment, 25% have since attended the STD clinic at least three times since diagnosis.

According to Falade-Nwulia, 3.2 million people in the US are living with HCV, and more than 50% are unaware of their infection. She said that people unaware of their infection are more likely to be uninsured and lack a usual source of health care. In addition, blacks and Hispanics have double the risk for infection compared with non-Hispanic whites.

“Public STD clinics see minority, poor and uninsured clients with high STD rates,” Falade-Nwulia said. “STD clinics have the potential to serve as HCV testing and treatment sites for these populations.” — by Emily Shafer

For more information:

Falade-Nwulia O. Abstract 1291. Presented at: IDWeek 2014; Oct. 8-12; Philadelphia.

Disclosure: Falade-Nwulia reports no relevant financial disclosures.