CME: A Program to Rapidly Test for Hepatitis C

CME: A Program to Rapidly Test for Hepatitis C

An ED screening and diagnostic testing program found a high prevalence of hepatitis C. Results suggest that continued efforts are needed to develop and evaluate policies for ED-based hepatitis C screening.   Hepatitis C virus affects about 3 million Americans and is a leading cause of end-stage liver disease, hepatocellular carcinoma, and liver transplants. National recommendations endorse using risk-based hepatitis C screening, which includes screening patients with a history of injection drug use as well as one-time screenings of “baby boomers,” or patients born between 1945 and 1965. Current data suggest that the baby boomer generation accounts for 75% of people infected with hepatitis C, but 1.25 to 1.75 million of them are unaware that they are infected. “Hepatitis C screening has long been considered impractical for EDs, but advances in rapid testing technology, the development of new therapies, and improvements in reimbursement for selective screening has created new opportunities to implement these screenings in the ED setting,” says Douglas A.E. White, MD. Despite these advances, clinical experience with hepatitis C virus screening in EDs is limited.   Testing a New Program Recently, Dr. White and colleagues at Alameda Health System implemented an ED-based screening program for both HIV and hepatitis C into the triage process according to recommendations from the CDC and United States Preventive Services Task Force. As an adjunct to screening, physicians could order HIV and hepatitis C testing when clinically indicated. For a study published in Annals of Emergency Medicine, the research team reported results of the hepatitis C portion of this screening program. The primary objective was to determine the prevalence of hepatitis C...
A Program to Rapidly Test for Hepatitis C

A Program to Rapidly Test for Hepatitis C

An ED screening and diagnostic testing program found a high prevalence of hepatitis C. Results suggest that continued efforts are needed to develop and evaluate policies for ED-based hepatitis C screening.   Hepatitis C virus affects about 3 million Americans and is a leading cause of end-stage liver disease, hepatocellular carcinoma, and liver transplants. National recommendations endorse using risk-based hepatitis C screening, which includes screening patients with a history of injection drug use as well as one-time screenings of “baby boomers,” or patients born between 1945 and 1965. Current data suggest that the baby boomer generation accounts for 75% of people infected with hepatitis C, but 1.25 to 1.75 million of them are unaware that they are infected. “Hepatitis C screening has long been considered impractical for EDs, but advances in rapid testing technology, the development of new therapies, and improvements in reimbursement for selective screening has created new opportunities to implement these screenings in the ED setting,” says Douglas A.E. White, MD. Despite these advances, clinical experience with hepatitis C virus screening in EDs is limited.   Testing a New Program Recently, Dr. White and colleagues at Alameda Health System implemented an ED-based screening program for both HIV and hepatitis C into the triage process according to recommendations from the CDC and United States Preventive Services Task Force. As an adjunct to screening, physicians could order HIV and hepatitis C testing when clinically indicated. For a study published in Annals of Emergency Medicine, the research team reported results of the hepatitis C portion of this screening program. The primary objective was to determine the prevalence of hepatitis C...
Eliminating Screening Barriers for HCV

Eliminating Screening Barriers for HCV

Approximately 3.9 million Americans are chronically infected with the hepatitis C virus (HCV), making it the most common chronic bloodborne infection in the United States, according to the CDC. If left untreated, HCV can result in serious organ damage to the liver and kidneys as well as premature death. On average, HCV patients die 20 years earlier than those without the infection. Research shows that HCV symptoms often do not manifest for decades and patient awareness of their infection status is low. Despite recent advances in therapeutics, diagnostic assessments, technology and public health policy for HCV, research suggests that a substantial number of people remain undiagnosed and untreated. Facilitating access to new therapies is paramount to making progress in the fight against HCV. Many stakeholders are working to develop solutions to address the cost of direct-acting antiviral agents, but access to therapy is just one of the barriers to reducing disease incidence. One of the most important barriers in care involves the quality of screening and diagnosis. Published guidelines from the CDC and United States Task Force for Preventive Services have helped guide clinicians on who should be screened, including baby boomers born between 1945 and 1965, and how to screen them. Unfortunately, screening often involves a two-step approach to testing. When patients receive a positive antibody screen, they may need to return for a subsequent doctor’s visit and blood draw to produce a specimen on which to perform a molecular test to confirm active infection. Studies indicate that as many as 60% of patients who receive a positive antibody screening test for hepatitis C in the U.S. do...