Implementation of baby boomer hepatitis C screening and linking to care in gastroenterology practices: a multi-center pilot study

BMC Gastroenterology

Research Article

John J. Santoro¹  Lisa Pedicone²  Idania Lio²  Zobair M. Younossi³  Andrei Racila⁴  Sharon Hunt⁴  Fatema Nader⁴  Maria Stepanova⁴  Victor Araya⁵  Louis L. LaLuna⁶  Natarajan Ravendhran⁷  Flavia Mendes⁸ 

[1] AGA Clinical Research Associates, LLC, Egg Harbor Township, NJ, USA;Cantara Clinical Solutions, LLC, Morristown, NJ, USA;Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA;Center for Outcomes Research in Liver Diseases, Washington, DC, USA;Betty and Guy Beatty Center for Integrated Research, Claude Moore Health Education and Research Building, 3300 Gallows Road, 22042, Falls Church, VA, USA;Center for Outcomes Research in Liver Diseases, Washington, DC, USA;Central Bucks Specialists, Gastroenterology, Doylestown, PA, USA;Digestive Disease Associates, Wyomissing, PA, USA;Digestive Diseases Associates, Catonsville, MD, USA;GastroHealth, Miami, FL, USA;

关键词: Baby Boomer;    Sustain Viral Response;    HRQL Score;    Gastroenterology Practice;    High Efficacy Drug;   

DOI  :  10.1186/s12876-016-0438-z

 received in 2015-11-13, accepted in 2016-02-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundEstimates suggest that only 20 % of HCV-infected patients have been identified and <10 % treated. However, baby boomers (1945-1965) are identified as having a higher prevalence of HCV which has led the Centers for Disease Control and Prevention to make screening recommendations. The aim of this study was to implement the CDC’s screening recommendations in the unique setting of gastroenterology practices in patients previously unscreened for HCV.MethodsAfter obtaining patient informed consent, demographics, clinical and health-related quality of life (HRQOL) data were collected. A blood sample was screened for HCV antibody (HCV AB) using the OraQuick HCV Rapid Antibody Test. HCV AB-positive patients were tested for presence of HCV RNA and, if HCV RNA positive, patients underwent treatment discussions.ResultsWe screened 2,000 individuals in 5 gastroenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid-Atlantic and 1 Southeast). Of the screened population, 10 individuals (0.5 %) were HCV AB-positive. HCV RNA testing was performed in 90 % (9/10) of HCV AB-positive individuals. Of those, 44.4 % (4/9) were HCV RNA-positive, and all 4 (100 %) were linked to caregiver. Compared to HCV AB negative subjects, HCV AB-positive individuals tended to be black (20.0 vs. 5.2 %, p = 0.09) and reported significantly higher rates of depression: 60.0 vs. 21.5 %, p = 0.009. These individuals also reported a significantly lower HRQOL citing having more fatigue, poorer concentration, and a decreased level of energy (p < 0.05).DiscussionAlthough the prevalence of HCV AB-positive was low in previously unscreened subjects screened in the gastroenterology centers, the linkage to care was very high. The sample of patients used in this study may be biased, so further studies are needed to assess the effectiveness of the CDC screening recommendations.ConclusionImplementation of the Baby Boomer Screening for HCV requires identifying screening environement with high prevalence of HCV+ individuals as well as an efficient process of linking them to care.

【 授权许可】

CC BY   
© Younossi et al. 2016