HCV among The Miriam Hospital and Rhode Island Hospital Adult ED Patients

Abstract

The Emergency Department (ED) appears to be an ideal place to conduct hepatitis C virus (HCV) screening. We aimed to estimate the prevalence of prior HCV test positivity among adult (18-64 year-old) patients at The Miriam Hospital and Rhode Island Hospital EDs, as well as the undiagnosed HCV antibody seroprevalence among patients with any self-reported injection or non-injection drug use who agreed to undergo rapid HCV antibody testing. The prevalence of prior HCV test positivity among 8,500 adult ED patients was approximately 4.6%, and the previously undiagnosed HCV antibody seroprevalence among 621 drug-using adult ED patients was 1.6%. Among the ten ED patients with a positive rapid HCV antibody test not previously diagnosed, eight were born after 1965 and six never had injected drugs. If current HCV screening recommendations were followed exclusively in this setting, this practice would have missed half of those with a positive rapid HCV antibody test.

Trial registration: ClinicalTrials.gov NCT01124591 NCT01419899.

Keywords: emergency medicine; hepatitis C; mass screening; seroepidemiologic studies; substance abuse.

Figure 1

InVITED and BIDMED studies HCV positive test history and HCV antibody test prevalence Key: ED = Emergency Department; EMR = Electronic Medical Record; HCV = Hepatitis C Virus