Hepatitis C Testing Guidelines Leave Many Undiagnosed

Author(s):

Laurie Toich, Assistant Editor

Current CDC testing guidelines fall short of solving the problem of undiagnosed patients with hepatitis C.

The guideline for hepatitis C virus (HCV) set by the US Centers for Disease Control and Prevention (CDC) leaves up to one-quarter of patients undiagnosed, a study published in Clinical Infectious Diseases reports.

The CDC recommends that anyone born between 1945 and 1965, is an injection drug user, or uses clotting factors receives one-time HCV testing. Researchers at The Johns Hopkins Hospital expanded their testing to any patient over 18 who had their blood drawn and was not known to be HCV antibody-positive.

The study was conducted between June 2013 and August 2013. They examined blood samples from 4713 patients who visited their emergency department (ED).

Of the patients tested, 652 were HCV antibody-positive, while 204 of those participants had undocumented HCV infection. Patients born between 1945 and 1965 had an HCV prevalence rate of 25% and also had higher prevalence of undocumented HCV.

Researchers also found that non-African American patients had an HCV prevalence rate of up to 7.6%.

There were 204 patients with undocumented HCV and only 128 were born between 1945 and 1965. There were 45 injection users and 10 patients with HIV that also had undocumented HCV.

"Had we established an emergency room HCV testing program with just these guidelines, 51 patients (25 percent) with undocumented HCV would not have been identified during our study period," Yu-Hsiang Hsieh, PhD, said in a press release. "Given an estimated 7727 unique ED patients with HCV infection in a one-year period, birth cohort testing would identify 1815 undocumented infections, but universal testing would identify an additional 526 cases."

Researchers believe that federal and state HCV management/treatment resources are needed. The researchers also state that they can examine cost-effective ways to screen patients for HCV.

"It's not often that we get to say we can cure a medical condition," Dr. Hsieh said. "So when we can, we should implement protocols that allow us to easily identify those in need."