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ED Screening Finds High Rates of HCV in Unaware Baby Boomers

October 6th, 2016

OAKLAND, CA – Many Baby Boomers visiting an urban emergency department got some surprise – and likely unwelcome – news. They tested positive for hepatitis C.

High rates of infection were found among intravenous drug users and Baby Boomers, typically defined as those born between 1946 and 1964, according to results of a screening and rapid diagnostic testing program for hepatitis C. The online report in Annals of Emergency Medicine also notes that three-quarters were unaware they were infected.

"Given skyrocketing rates of injection heroin use around the country, we expect the already high rates of hepatitis C infection to explode," said lead study author Douglas White, MD, of Highland Hospital, part of the Alameda Health System in Oakland, CA. "Intervention by emergency departments, in the form of screening and referral for treatment, could help slow the spread of this potentially deadly, communicable disease."

During the screening program, researchers tested 10% of ED patients for hepatitis C virus (HCV), mostly but not exclusively testing those considered high-risk, such as intravenous drug users, Baby Boomers and patients with unspecified liver disease. Of patients tested, 10.3% tested positive for HCV with most of them, 70%, confirmed as chronically infected.

Among the factors associated with testing positive for hepatitis C virus included:

  • injection drug use
  • homelessness
  • birth cohort, i.e. being a Baby Boomer
  • male sex

The ED arranged follow-up appointments at the hepatitis C virus clinic for 57 of the 126 patients with confirmed positive results, and 30 showed up.

"In addition to the myriad public health functions they already perform, urban emergency departments may play an important role as safety net providers for HCV screening," White said in an American College of Emergency Physicians news release. "We have a better than even chance of reaching many of the three million people who are infected since they tend to be heavy emergency department users already. It gives us a chance to connect these people to ongoing care at HCV clinics or elsewhere in the health care system."

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