Implementation of baby boomer hepatitis C screening and linking to care in gastroenterology practices: a multi-center pilot study

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Background:
Estimates suggest that only 20 % of HCV-infected patients have been identified and <10 % treated. However, baby boomers (1945-1965) are identified as having a higher prevalence of HCV which has led the Centers for Disease Control and Prevention to make screening recommendations. The aim of this study was to implement the CDC’s screening recommendations in the unique setting of gastroenterology practices in patients previously unscreened for HCV.

Methods:
After obtaining patient informed consent, demographics, clinical and health-related quality of life (HRQOL) data were collected. A blood sample was screened for HCV antibody (HCV AB) using the OraQuick HCV Rapid Antibody Test. HCV AB-positive patients were tested for presence of HCV RNA and, if HCV RNA positive, patients underwent treatment discussions.

Results:
We screened 2,000 individuals in 5 gastroenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid-Atlantic and 1 Southeast). Of the screened population, 10 individuals (0.5 %) were HCV AB-positive. HCV RNA testing was performed in 90 % (9/10) of HCV AB-positive individuals. Of those, 44.4 % (4/9) were HCV RNA-positive, and all 4 (100 %) were linked to caregiver. Compared to HCV AB negative subjects, HCV AB-positive individuals tended to be black (20.0 vs. 5.2 %, p = 0.09) and reported significantly higher rates of depression: 60.0 vs. 21.5 %, p = 0.009. These individuals also reported a significantly lower HRQOL citing having more fatigue, poorer concentration, and a decreased level of energy (p < 0.05).

Discussion:
Although the prevalence of HCV AB-positive was low in previously unscreened subjects screened in the gastroenterology centers, the linkage to care was very high. The sample of patients used in this study may be biased, so further studies are needed to assess the effectiveness of the CDC screening recommendations.

Conclusion:
Implementation of the Baby Boomer Screening for HCV requires identifying screening environement with high prevalence of HCV+ individuals as well as an efficient process of linking them to care.

Autoři: Zobair M. Younossi ^1,2,9*; Louis L. Laluna ³; John J. Santoro ⁴; Flavia Mendes ⁵; Victor Araya ⁶; Natarajan Ravendhran ⁷; Lisa Pedicone ⁸; Idania Lio ⁸; Fatema Nader ²; Sharon Hunt ²; Andrei Racila ²; Maria Stepanova ²
Působiště autorů: Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA. ¹; Center for Outcomes Research in Liver Diseases, Washington, DC, USA. ²; Digestive Disease Associates, Wyomissing, PA, USA. ³; AGA Clinical Research Associates, LLC, Egg Harbor Township, NJ, USA. ⁴; GastroHealth, Miami, FL, USA. ⁵; Central Bucks Specialists, Gastroenterology, Doylestown, PA, USA. ⁶; Digestive Diseases Associates, Catonsville, MD, USA. ⁷; Cantara Clinical Solutions, LLC, Morristown, NJ, USA. ⁸; Betty and Guy Beatty Center for Integrated Research, Claude Moore Health Education and Research Building, 3300 Gallows Road, Falls Church, VA 22042, USA. ⁹
Vyšlo v časopise: BMC Gastroenterology 2016, 16:45
Kategorie: Research article
prolekare.web.journal.doi_sk: https://doi.org/10.1186/s12876-016-0438-z

© 2016 Younossi et al.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-016-0438-z

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