Hepatitis C virus screening practices and seropositivity among US veterans born during 1945 – 1965

BMC Research Notes

David Rimland³  Christopher Rentsch¹  Emily J Cartwright² 

[1] Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, Georgia 30033, USA;Division of Infectious Diseases, Emory University School of Medicine, 49 Jesse Hill Dr, Atlanta, Georgia 30303, USA;Division of Infectious Diseases, Emory University School of Medicine, Veterans Affairs Medical Center, 1670 Clairmont Road, Decatur, Georgia 30033, USA

关键词: control;    Prevention &;    Screening;    Hepatitis C;   

Others  :  1131924
DOI  :  10.1186/1756-0500-7-449

 received in 2014-06-23, accepted in 2014-07-01,  发布年份 2014

【 摘 要 】

Background

The Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force (USPSTF) recently augmented risk-based hepatitis C (HCV) screening guidelines with a recommendation to perform one-time screening in all persons born during 1945 – 1965, a birth cohort known to have a higher prevalence of HCV. We sought to estimate the proportion of veterans seen at the Atlanta VA Medical Center (AVAMC) who had ever been screened for HCV infection by birth year.

Methods

We used an administrative database of all veterans seen at the AVAMC between January 1, 2011 and December 31, 2011, and a laboratory generated list of all HCV antibody tests and HCV RNA viral loads that were performed at the AVAMC to determine receipt of screening and HCV antibody positivity. Odds ratios and 95% confidence intervals were estimated using SAS version 9.2 (SAS institute, Cary, North Carolina).

Results

HCV antibody testing had ever been performed on 48% (41,556) of the veterans seen in 2011; 10% of those tested had a positive antibody. Confirmatory viral loads were performed in 96% of those with a positive antibody screen. Those born during 1945 – 1965 were more likely to have a HCV antibody performed when compared with those born in other years (54% vs. 41%, odds ratio [OR] 1.70, 95% Confidence Interval [CI] 1.65-1.74). Among veterans ever tested for HCV antibody (n = 41,556), those born during 1945 – 1965 were 6 times more likely to have a positive HCV antibody (15% vs. 3%, OR 5.87, 95% CI 5.32-6.78), and 3 times more likely to have chronic HCV infection (76% vs. 50%, OR 3.25, 95% CI 2.65-4.00).

Conclusions

Nearly half of the veterans seen in 2011 at the AVAMC had ever been tested for HCV infection. When examined by birth cohort, over half of the veterans born during 1945 – 1965 had been screened for HCV and 15% of those screened had a positive HCV antibody. Our findings confirm the increased prevalence of HCV infection in persons born during 1945 – 1965 as identified in the updated CDC and USPSTF recommendations.

【 授权许可】

   
2014 Cartwright et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Centers for Disease Control and Prevention: Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR 1998, 47(No. RR-19):1-39.
• [2]Centers for Disease Control and Prevention: Public health service inter-agency guidelines for screening donors of blood, plasma, organs, tissue, and semen for evidence of hepatitis B and hepatitis C. MMWR 1991, 40(RR-4):1-17.
• [3]Hepatitis C testing and prevention counseling guidelines for VA health care practitioners http://www.hepatitis.va.gov/ webcite
• [4]Smith BD, Morgan RL, Beckett GA, Falck-Ytter Y, Holtzman D, Teo CG, Jewett A, Baack B, Rein DB, Patel N, Alter M, Yartel A, Ward JW: Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945–1965. MMWR Recomm Rep 2012, 61(RR-4):1-32.
• [5]Southern WN, Drainoni ML, Smith BD, Christiansen CL, McKee D, Gifford AL, Weinbaum CM, Thompson D, Koppelman E, Maher S, Litwin AH: Hepatitis C testing practices and prevalence in a high-risk urban ambulatory care setting. J Viral Hepat 2011, 18(7):474-481.
• [6]Chou R, Cottrell EB, Wasson N, Rahman B, Guise JM: Screening for hepatitis C virus infection in adults: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2013, 158(2):101-108.
• [7]Backus LI, Belperio PS, Loomis TP, Yip GH, Mole LA: Hepatitis C virus screening and prevalence among US veterans in Department of Veterans Affairs care. JAMA Intern Med 2013, 173(16):1549-1552.
• [8]Almario CV, Vega M, Trooskin SB, Navarro VJ: Examining hepatitis C virus testing practices in primary care clinics. J Viral Hepat 2012, 19(2):e163-e169.
• [9]Shatin D, Schech SD, Patel K, McHutchison JG: Population-based hepatitis C surveillance and treatment in a national managed care organization. Am J Manag Care 2004, 10(4):250-256.
• [10]Litwin AH, Smith BD, Drainoni ML, McKee D, Gifford AL, Koppelman E, Christiansen CL, Weinbaum CM, Southern WN: Primary care-based interventions are associated with increases in hepatitis C virus testing for patients at risk. Dig Liver Dis 2012, 44(6):497-503.
• [11]Briggs ME, Baker C, Hall R, Gaziano JM, Gagnon D, Bzowej N, Wright TL: Prevalence and risk factors for hepatitis C virus infection at an urban Veterans Administration medical center. Hepatology 2001, 34(6):1200-1205.
• [12]Brau N, Bini EJ, Shahidi A, Aytaman A, Xiao P, Stancic S, Eng R, Brown ST, Paronetto F: Prevalence of hepatitis C and coinfection with HIV among United States veterans in the New York City metropolitan area. Am J Gastroenterol 2002, 97(8):2071-2078.
• [13]Sloan KL, Straits-Troster KA, Dominitz JA, Kivlahan DR: Hepatitis C tested prevalence and comorbidities among veterans in the US Northwest. J Clin Gastroenterol 2004, 38(3):279-284.
• [14]Cheung RC: Epidemiology of hepatitis C virus infection in American veterans. Am J Gastroenterol 2000, 95(3):740-747.
• [15]Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ: The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med 2006, 144(10):705-714.
• [16]Armstrong GL: Injection drug users in the United States, 1979–2002: an aging population. Arch Intern Med 2007, 167(2):166-173.
• [17]Murphy EL, Fang J, Tu Y, Cable R, Hillyer CD, Sacher R, Triulzi D, Gottschall JL, Busch MP: Hepatitis C virus prevalence and clearance among US blood donors, 2006–2007: associations with birth cohort, multiple pregnancies, and body mass index. J Infect Dis 2010, 202(4):576-584.
• [18]McDonald SA, Hutchinson SJ, Schnier C, McLeod A, Goldberg DJ: Estimating the number of injecting drug users in Scotland's HCV diagnosed population using capture-recapture methods. Epidemiol Infect 2014, 142(1):200-207.
• [19]Balogun MA, Ramsay ME, Hesketh LM, Andrews N, Osborne KP, Gay NJ, Morgan-Capner P: The prevalence of hepatitis C in England and Wales. J Infect 2002, 45(4):219-226.
• [20]Nerrienet E, Pouillot R, Lachenal G, Njouom R, Mfoupouendoun J, Bilong C, Mauclere P, Pasquier C, Ayouba A: Hepatitis C virus infection in cameroon: a cohort-effect. J Med Virol 2005, 76(2):208-214.
• [21]Page K, Hahn JA, Evans J, Shiboski S, Lum P, Delwart E, Tobler L, Andrews W, Avanesyan L, Cooper S, Busch MP: Acute hepatitis C virus infection in young adult injection drug users: a prospective study of incident infection, resolution, and reinfection. J Infect Dis 2009, 200(8):1216-1226.
• [22]Wang CC, Krantz E, Klarquist J, Krows M, McBride L, Scott EP, Shaw-Stiffel T, Weston SJ, Thiede H, Wald A, Rosen HR: Acute hepatitis C in a contemporary US cohort: modes of acquisition and factors influencing viral clearance. J Infect Dis 2007, 196(10):1474-1482.
• [23]van der Berg CH, Grady BP, Schinkel J, van de Laar T, Molenkamp R, van Houdt R, Coutinho RA, van Baarle D, Prins M: Female sex and IL28B, a synergism for spontaneous viral clearance in hepatitis C virus (HCV) seroconverters from a community-based cohort. Plos One 2011, 6(11):e27555.
• [24]Grebely J, Page K, Sacks-Davis R, van der Loeff MS, Rice TM, Bruneau J, Morris MD, Hajarizadeh B, Amin J, Cox AL, Kim AY, McGovern BH, Schinkel J, George J, Shoukry NH, Lauer GM, Maher L, Lloyd AR, Hellard M, Dore GJ, Prins M: The effects of female sex, viral genotype, and IL28B genotype on spontaneous clearance of acute hepatitis C virus infection. Hepatology 2014, 59:109-120.
• [25]Vital signs: evaluation of hepatitis C virus infection testing and reporting - eight U.S. sites, 2005–2011 MMWR Morb Mortal Wkly Rep 2013, 62(18):357-361.
• [26]Centers for Disease Control and Prevention: Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR 2013, 62(18):357-361.
• [27]Liang TJ, Ghany MG: Current and future therapies for hepatitis C virus infection. N Engl J Med 2013, 368(20):1907-1917.
• [28]Veldt BJ, Heathcote EJ, Wedemeyer H, Reichen J, Hofmann WP, Zeuzem S, Manns MP, Hansen BE, Schalm SW, Janssen HL: Sustained virologic response and clinical outcomes in patients with chronic hepatitis C and advanced fibrosis. Ann Intern Med 2007, 147(10):677-684.
• [29]Cardoso AC, Moucari R, Figueiredo-Mendes C, Ripault MP, Giuily N, Castelnau C, Boyer N, Asselah T, Martinot-Peignoux M, Maylin S, Carvalho-Filho RJ, Valla D, Bedossa P, Marcellin P: Impact of peginterferon and ribavirin therapy on hepatocellular carcinoma: incidence and survival in hepatitis C patients with advanced fibrosis. J Hepatol 2010, 52(5):652-657.
• [30]van der Meer AJ, Veldt BJ, Feld JJ, Wedemeyer H, Dufour JF, Lammert F, Duarte-Rojo A, Heathcote EJ, Manns MP, Kuske L, Zeuzem S, Hofmann WP, de Knegt RJ, Hansen BE, Janssen HL: Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA 2012, 308(24):2584-2593.
• [31]Morgan TR, Ghany MG, Kim HY, Snow KK, Shiffman ML, De Santo JL, Lee WM, Di Bisceglie AM, Bonkovsky HL, Dienstag JL, Morishima C, Lindsay KL, Lok AS: Outcome of sustained virological responders with histologically advanced chronic hepatitis C. Hepatology 2010, 52(3):833-844.