scholarly journals Opt-out HIV and Hepatitis C Testing at the Dallas County Jail: Uptake, Prevalence, and Demographic Characteristics of Testers

2017 ◽  
Vol 132 (6) ◽  
pp. 617-621 ◽  
Author(s):  
Carolina de la Flor ◽  
Esmaeil Porsa ◽  
Ank E. Nijhawan
Keyword(s):  
Hepatitis C ◽  
Baby Boomers ◽  
County Jail ◽  
Dallas County ◽  
Opt Out ◽  
High Prevalence ◽  
Antibody Positivity ◽  
Hcv Antibody ◽  
Hcv Testing ◽  
Hispanic White

Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection are common in the criminal justice system. We offered opt-out HIV/HCV testing at the Dallas County Jail during intake from June 2015 to November 2016, after which testing was integrated into routine phlebotomy processes. The uptake of testing increased from 12.9% (118/915) in June 2015 to 80.5% (269/334) in January 2016. HIV was confirmed in 1.0% (30/3155) of inmates; 6 were new diagnoses and all were linked to care. HCV antibody positivity was found in 16.4% (500/4042) of inmates. Sixty percent (155/258) of HCV-positive inmates born between 1945 and 1965 (ie, baby boomers) were non-Hispanic black, whereas 56.2% (136/242) born after 1965 were non-Hispanic white. Testing only baby boomers would have missed approximately half of HCV infections, predominantly among young, non-Hispanic white people. Future efforts should expand HIV and HCV testing in jails, as it is feasible, acceptable, and increases prevention and engagement in care for a high-prevalence, hard-to-reach population.

Test4HepC: Promoting Hepatitis C Testing to Baby Boomers Using Social Media

2019 ◽  
Vol 21 (5) ◽  
pp. 780-790 ◽  
Author(s):  
Aaron Plant ◽  
Emerald G. Snow ◽  
Jorge A. Montoya ◽  
Sean Young ◽  
Marjan Javanbakht ◽  
...  
Keyword(s):  
Social Media ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Qualitative Interviews ◽  
Antibody Test ◽  
The United States ◽  
Perceived Usefulness ◽  
Hcv Antibody ◽  
Hcv Testing ◽  
Test Result

Individuals born between 1945 and 1965 (“baby boomers”) account for an estimated three quarters of all hepatitis C (HCV) infections in the United States. This article describes the evaluation of Test4HepC, a program that uses social media and a website to promote HCV testing to baby boomers in Los Angeles County, California. The first 16 months of Test4HepC were evaluated using an online survey (n = 302), qualitative interviews (n = 20), website and social media analytics, and records of free testing offered though the program. Test4HepC.org had 6,919 visitors; 48 individuals used the free testing offered. Within 1 month of visiting the website, 24.5% (74) of survey participants tested for HCV, 67.6% (50) received a negative HCV antibody test result, 2.7% (2) received a positive HCV antibody test result, and 25.7% (19) had not received their results as of taking the survey. Most of those not tested (60.5%) reported intention to test. In multivariable analysis, male sex and high perceived usefulness of the program website were associated with HCV testing. Qualitative interviews suggested that Test4HepC increased baby boomers’ HCV risk perception and encouraged testing. Social media is a promising strategy for promoting HCV testing to baby boomers. Expanding Test4HepC to other areas and prioritizing the highest risk baby boomers could enable many people with HCV to benefit from new treatments.

scholarly journals Hepatitis C virus (HCV) in Scotland: latest diagnoses to 2003 and prevention recommendations 2004

2004 ◽  
Vol 8 (31) ◽  
Author(s):  
D Goldberg ◽  
Louise Shaw ◽  
G Codere ◽  
Kirsty Roy ◽  
S Hutchinson
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Testing Laboratories ◽  
Antibody Positivity ◽  
Hcv Antibody ◽  
Hcv Testing

During 2003, 1779 new cases of hepatitis C virus (HCV) antibody positivity were diagnosed by HCV testing laboratories throughout Scotland

scholarly journals Correlates of Hepatitis C Virus Infection in the Targeted Testing Program of the New York City Jail System

2016 ◽  
Vol 132 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Matthew J. Akiyama ◽  
Fatos Kaba ◽  
Zachary Rosner ◽  
Howard Alper ◽  
Aimee Kopolow ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
York City ◽  
Public Health Intervention ◽  
Hcv Infection ◽  
Antibody Positivity ◽  
Hcv Antibody ◽  
Hispanic White

Objective: The objective of this study was to understand predictors of hepatitis C virus (HCV) antibody positivity in a large urban jail system in New York City. Methods: We examined demographic characteristics, risk behaviors, and HCV antibody prevalence among 10 790 jail inmates aged 16 to 86 who were screened from June 13, 2013, to June 13, 2014, based on birth cohort or conventional high-risk criteria. We used logistic regression analysis to determine predictors of HCV antibody positivity. Results: Of the 10 790 inmates screened, 2221 (20.6%) were HCV antibody positive. In the multivariate analysis, HCV antibody positivity was associated most strongly with injection drug use (IDU; adjusted odds ratio [aOR] = 35.0; 95% confidence interval [CI], 28.5-43.0). Women were more likely than men to be infected with HCV (aOR = 1.3; 95% CI, 1.1-1.5). Compared with non-Hispanic black people, Hispanic (aOR = 2.1; 95% CI, 1.8-2.4) and non-Hispanic white (aOR = 1.7; 95% CI, 1.5-2.1) people were more likely to be infected with HCV. Non-IDU, recidivism, HIV infection, homelessness, mental illness, and lower education level were all significantly associated with HCV infection. The prevalence rate of HCV infection among a subset of inmates born after 1965 who denied IDU and were not infected with HIV was 5.6% (198 of 3529). Predictors of HCV infection among this group included non-IDU as well as being non-Hispanic white, Hispanic, recidivist, and homeless. Conclusion: These data reveal differences in HCV infection by sex, race/ethnicity, and socioeconomics in a large jail population, suggesting that a focused public health intervention is required and that universal screening may be warranted. Further sensitivity and cost-benefit analyses are needed to make this determination.

scholarly journals Measuring trends in hepatitis C testing with commercial laboratory data

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
William W Thompson ◽  
Harvey W. Kaufman ◽  
Noele P. Nelson
Keyword(s):  
United States ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Task Force ◽  
Laboratory Data ◽  
The United States ◽  
Antibody Testing ◽  
Commercial Laboratory ◽  
Hcv Antibody ◽  
Hcv Testing

ObjectiveUsing the two largest commercial laboratory data sources nationally, we estimated the annual rates of hepatitis C testing among individuals who were recommended to be tested (i.e., baby boomer cohort born between 1945 and 1965) by the CDC and United States Preventive Services Task Force. This panel will discuss strengths and weaknesses for monitoring hepatitis C testing using alternative data sources including self-reported data, insurance claims data, and laboratory testing data.IntroductionHepatitis C virus (HCV) infection is a leading cause of liver disease-related morbidity and mortality in the United States. Approximately 75% of people infected with chronic HCV were born between 1945 and 1965. Since 2012, the CDC has recommended one-time screening for chronic HCV infection for all persons in this birth cohort (baby boomers). The United States Preventive Services Task Force (USPSTF) subsequently made the same recommendation in June 2013. We estimated the rate of HCV testing between 2011 and 2017 among persons with commercial health insurance coverage and compared rates by birth cohort.MethodsHepatitis C virus testing data were obtained from Quest Diagnostics (Quest) and Laboratory Corporation of America (LabCorp), two large U.S. commercial laboratories serving clinicians and hospitals in all 50 U.S states and the District of Columbia. Analysis was based on de-identified person-level data from HCV antibody immunoassay tests ordered by clinicians in the U.S. between 2011 and in 2017 (with LabCorp data in 2017 limited to January through October). HCV antibody testing rates were calculated and defined as: the number of unique individuals who received their first HCV antibody test during a particular month per 100 unique individuals who had any laboratory test performed by the commercial laboratory during the same month, presented as an annual average (mean) testing rate. Persons born between 1945 and 1965 were classified as baby boomers and compared to persons born in all other years.ResultsIn 2011, prior to the CDC recommendation change, rates of HCV antibody testing relative to overall testing with each cohort were higher for the non-baby boomer cohort served by both Quest and LabCorp. In contrast, from 2012 thorugh2017, testing was more frequent among baby boomers than among non-baby boomers as a proportion of overall testing in each cohort. The rate of testing among baby boomers served by Quest rose from 1.7 per 100 test requests in 2011 to 3.8 per 100, an increase of 131%, while the rate of testing among non-baby boomers rose from 2.3 per 100 to 3.1 per 100, a 35% increase. Changes among patients served by LabCorp were nearly identical; a 132% increase among baby boomers (1.7 per 100 in 2011 to 4.0 per 100 in 2017) and a 31% increase among non-baby boomers (1.7 per 100 in 2011 to 3.2 per 100 in 2017).ConclusionsThis study demonstrates the utility of commercial laboratory data for assessing changes in HCV testing, as well as the potential impact of national recommendations supporting HCV testing of baby boomers. The study also highlights a prominent, the increase in HCV antibody testing in 2017 relative to 2011, prior to the recommendation change. 

scholarly journals Rapid point-of-care (POC) testing for Hepatitis C antibodies in a very high prevalence setting: persons injecting drugs in Tallinn, Estonia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anneli Uusküla ◽  
Ave Talu ◽  
Jürgen Rannap ◽  
David M. Barnes ◽  
Don Des Jarlais
Keyword(s):  
Hepatitis C ◽  
Point Of Care ◽  
Antibody Test ◽  
Hcv Rna ◽  
Test Results ◽  
Blood Draw ◽  
Persons Who Inject Drugs ◽  
Oral Swab ◽  
High Prevalence ◽  
Hcv Antibody

Abstract Background Between December 2018 and January of 2019, we evaluated the accuracy of the point-of-care Hepatitis C (HCV) antibody test (POC; OraQuick HCV) used at a community-based needle and syringe exchange program serving persons who inject drugs in Tallinn, Estonia. Methods We compared the results of screening for HCV antibodies by OraQuick (oral swab) and enzyme immunoassay (EIA; blood draw) and assessed test results implications in a high prevalence setting. Findings Of the 100 participants, 88 (88%) had reactive POC test results, and 93 were HCV antibody positive on EIA testing. Sensitivity, specificity and negative predictive value (NPV) for the POC assay with EIA as the relevant reference test were as follows: 94.6% (95% CI 90.0–99.2%), 100% and 58.3% (95% CI 30.4–86.2%). Of the 12 testing, HCV-negative with the POC only 7 (58.3%) were true negatives. Conclusions Oral swab rapid testing HCV screening in this nonclinical setting was sensitive and specific but had unacceptably low NPV. In high prevalence settings, POC tests with high sensitivity and that directly measure HCV RNA may be warranted.

scholarly journals 308. Slow Adoption of a Nurse-Driven Protocol for Universal Hepatitis C Virus Screening in a Hospital Emergency Department: Lessons Learned

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S165-S165
Author(s):  
Zainab Wasti ◽  
Dagan Coppock ◽  
Zsofia Szep ◽  
Tiffany Scott ◽  
Taneesa Franks ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Public Health Intervention ◽  
Lessons Learned ◽  
Seroprevalence Rate ◽  
Screening Protocol ◽  
Hcv Screening ◽  
Hcv Testing

Abstract Background In areas with a high prevalence of hepatitis C virus (HCV) infection, emergency department (ED) visits may provide unique opportunities for screening. The catchment area for Hahnemann University Hospital (HUH) has an HCV seroprevalence rate of >20%. However, limited data exist addressing HCV testing strategies in the ED. This study describes the experience of piloting a nurse-driven HCV screening protocol in an urban hospital ED. Methods A nurse-driven HCV screening protocol was developed and implemented on August 1, 2018. We performed a retrospective analysis of the protocol’s performance from July 1, 2018, through December 31, 2018. Patients who were evaluated in the ED and had blood collected were analyzed. We provided universal HCV screening regardless of age or risk factors. If HCV-positive by antibody screen and viral load confirmation, an attempt was made to link patients to care. Linkage was defined as having received an inpatient evaluation by either infectious diseases or hepatology physician. Results Among 20,705 unique patients seen in the ED, 7841 (38%) had blood work collected. 821 (10.5%) patients had HCV antibody testing. After the implementation of the nurse-driven protocol, the testing rate increased from 68/1340 (5.1%) to 753/6501 (11.6%). 260 Baby Boomers (born between 1945–1965) were screened, of which 60 (23.1%) had positive screens. 561 non-Baby Boomers were screened, of which 30 (5.4%) had positive screens. Barriers of implementing nurse-driven protocol were: (1) multiple steps of the ordering process in the electronic medical record (EMR), (2) the complexity of staff schedules, and (3) staff concerns regarding the disclosure of HCV test results. Among the patients who were diagnosed with chronic HCV, 60 % were linked to care for treatment. Conclusion We piloted a nurse-driven universal HCV testing protocol in the ED of a hospital with high HCV prevalence. Though the screening rate doubled, it was still low. We identified barriers that may be addressed to improve future screening rates. In areas with a high seroprevalence of HCV, universal screening may be an excellent public health intervention to identify asymptomatic HCV-infected patients. Disclosures All authors: No reported disclosures.

scholarly journals Clustering of hepatitis C virus antibody positivity within households and communities in Punjab, India

2019 ◽  
Vol 147 ◽  
Author(s):  
A. Trickey ◽  
A. Sood ◽  
V. Midha ◽  
W. Thompson ◽  
C. Vellozzi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Household Level ◽  
Individual Level ◽  
Ordered Logistic Regression ◽  
Antibody Positivity ◽  
Hcv Antibody ◽  
Level Model ◽  
Hepatitis C Virus Antibody

Abstract To better understand hepatitis C virus (HCV) epidemiology in Punjab state, India, we estimated the distribution of HCV antibody positivity (anti-HCV+) using a 2013–2014 HCV household seroprevalence survey. Household anti-HCV+ clustering was investigated (a) by individual-level multivariable logistic regression, and (b) comparing the observed frequency of households with multiple anti-HCV+ persons against the expected, simulated frequency assuming anti-HCV+ persons are randomly distributed. Village/ward-level clustering was investigated similarly. We estimated household-level associations between exposures and the number of anti-HCV+ members in a household (N = 1593 households) using multivariable ordered logistic regression. Anti-HCV+ prevalence was 3.6% (95% confidence interval 3.0–4.2%). Individual-level regression (N = 5543 participants) found an odds ratio of 3.19 (2.25–4.50) for someone being anti-HCV+ if another household member was anti-HCV+. Thirty households surveyed had ⩾2 anti-HCV+ members, whereas 0/1000 (P < 0.001) simulations had ⩾30 such households. Excess village-level clustering was evident: 10 villages had ⩾6 anti-HCV+ members, occurring in 31/1000 simulations (P = 0.031). The household-level model indicated the number of household members, living in southern Punjab, lower socio-economic score, and a higher proportion having ever used opium/bhuki were associated with a household's number of anti-HCV+ members. Anti-HCV+ clusters within households and villages in Punjab, India. These data should be used to inform screening efforts.

scholarly journals Hepatitis C Virus Infection in the Dallas County Jail: Implications for Screening, Prevention, and Linkage to Care

2019 ◽  
Vol 134 (6) ◽  
pp. 626-633
Author(s):  
Caroline M. Abe ◽  
Merilyne Aguwa ◽  
Michelle Zhao ◽  
Jacqueline Sullivan ◽  
Esmaeil Porsa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Linkage To Care ◽  
Hcv Infection ◽  
Hcv Rna ◽  
County Jail ◽  
Health Insurance Status ◽  
Dallas County ◽  
Hcv Antibody ◽  
Hcv Screening

Objectives: Screening for hepatitis C virus (HCV) infection in jail provides an opportunity to educate and offer care to a high-risk population. We aimed to (1) estimate the prevalence of HCV infection in jail; (2) describe the demographic characteristics, risk factors, and pre-incarceration health insurance status associated with HCV infection; and (3) examine the implementation of HCV screening in jail. Methods: We conducted a retrospective analysis of an opt-out HCV screening program with HCV RNA confirmation and patient education at the Dallas County Jail from April 1 through November 2, 2017. We extracted data on test results, demographic characteristics, and release destination from electronic medical records. A nurse navigator recorded data on patient self-reported risk factors and pre-incarceration health insurance status. Results: Of 4089 incarcerated persons screened, 708 (17.3%) had a positive HCV antibody result. Of these, 641 (90.5%) had an HCV RNA test ordered; 576 (89.9%) had RNA tests completed, of whom 413 (71.7%) had a positive HCV RNA result. Of these 413, 352 (85.2%) received patient education. Half of HCV RNA-positive incarcerated persons (n = 207, 50.1%) were born outside the birth cohort (1945-1965). Among those with HCV infection, commonly reported risk factors were injection drug use (168 of 352; 47.8%) and tattoos (82 of 352; 23.4%). Most incarcerated persons with HCV infection (284 of 350; 81.1%) did not have health insurance. HCV antibody prevalence was higher among incarcerated persons released to prison (232 of 961; 24.1%) than to outside agencies (38 of 403; 9.4%) or the community (178 of 1026; 17.4%). Conclusions: Screening for HCV with RNA confirmation in jail provides an opportunity for disease education, transmission prevention, and navigation to HCV treatment. Future efforts should examine post-incarceration linkage to care.

scholarly journals Implementation of a Large System-Wide Hepatitis C Virus Screening and Linkage to Care Program for Baby Boomers

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Mariana Castrejón ◽  
Kara W. Chew ◽  
Marjan Javanbakht ◽  
Romney Humphries ◽  
Sammy Saab ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Linkage To Care ◽  
Care Program ◽  
Hcv Rna ◽  
Care Coordinator ◽  
Hcv Antibody ◽  
Hcv Screening

Abstract Background We implemented and evaluated a large health system-wide hepatitis C virus (HCV) screening and linkage to care program for persons born between 1945 and 1965 (“baby boomers”). Methods An electronic health record (EHR) clinical decision support (CDS) tool for HCV screening for baby boomers was introduced in August 2015 for patients seen in the outpatient University of California, Los Angeles healthcare system setting. An HCV care coordinator was introduced in January 2016 to facilitate linkage to HCV care. We compared HCV testing in the year prior (August 2014–July 2015) to the year after (August 2015–July 2016) implementation of the CDS tool. Among patients with reactive HCV antibody testing, we compared outcomes related to the care cascade including HCV ribonucleic acid (RNA) testing, HCV RNA positivity, and linkage to HCV specialty care. Results During the study period, 19606 participants were screened for HCV antibody. Hepatitis C virus antibody screening increased 145% (from 5676 patients tested to 13930 tested) after introduction of the CDS intervention. Screening increased across all demographic groups including age, sex, and race/ethnicity, with the greatest increases among those in the older age groups. The addition of an HCV care coordinator increased follow-up HCV RNA testing for HCV antibody positive patients from 83% to 95%. Ninety-four percent of HCV RNA positive patients were linked to care postimplementation. Conclusions Introduction of an EHR CDS tool and care coordination markedly increased the number of baby boomers screened for HCV, rates of follow-up HCV RNA testing, and linkage to specialty HCV care for patients with chronic HCV infection.

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