Patients with Hepatitis C Virus Often Do Not Know They Are Infected

More than three-quarters of intravenous drug users and Baby Boomers tested for hepatitis C were positive and unaware they were infected, according to results of a study published in the journal Annals of Emergency Medicine.

Researchers from Highland Hospital in Oakland, California examined an ED hepatitis C testing program encompassing a birth cohort screening and screening of patients with a history of injection drug use combined with physician diagnostic testing.

The researchers aimed to evaluate factors associated with testing positive with logistic regression in more than 25,000 unique individuals aged 18 years or older. The participants were recruited during a 6-month span.

About 10% of the patients completed hepatitis C screening (about 2000 patients), while 553 completed diagnostic testing. Of those, the hepatitis C prevalence was 10.3%.

Injection drug use was the foremost factor linked to a positive hepatitis C screening, at 38.4% prevalence. This was followed by homelessness (25.5% prevalence), diagnostic testing (14.8% prevalence), birth cohort (13.7% prevalence), and male sex (12.4% prevalence).

Of the 267 patients who tested positive for the hepatitis C antibody, half had documentation of results and two thirds had confirmatory ribonucleic acid testing performed — and 70% of those patients had a positive result.

Follow up appointments for 57 of the 126 confirmed hepatitis C positive patients were arranged at the clinic. Thirty patients attended those appointments.

“Given skyrocketing rates of injection heroin use around the country, we expect the already high rates of hepatitis C infection to explode,” lead study author Douglas White, MD, explained in a press release. “Intervention by ED, in the form of screening and referral for treatment, could help slow the spread of this potentially deadly, communicable disease.”

The results lead the researchers to speculate that up to 4% of Baby Boomers — adults born between 1945 and 1965 – may be infected. That’s approximately 1.75 million adults, or about 75% of the total American population living with hepatitis C.

“In addition to the myriad public health functions they already perform, urban ED may play an important role as safety net providers for hepatitis C screening,” White said. “We have a better than even chance of reaching many of the three million people who are infected since they tend to be heavy ED users already. It gives us a chance to connect these people to ongoing care at hepatitis C clinics or elsewhere in the health care system.”