Targeted HCV Testing Misses High Number of Cases in Prisons
Findings based on birth cohort, risk-based testing vs opt-out testing in prison system.
HealthDay News — Targeted hepatitis C virus (HCV) testing misses a substantial number of cases among individuals in correctional facilities, according to a study published online Nov. 19 in the American Journal of Preventive Medicine.
Sabrina A. Assoumou, MD, MPH, from Boston University, and colleagues retrospectively analyzed data from individuals entering the Washington State prison system (2012 through 2016), which routinely offers HCV testing. The authors sought to compare routine opt-out with current recommendations for risk-based and one-time testing for individuals born between 1945 and 1965.
The researchers found that during the study period, 24,567 individuals (83%) were tested for the HCV antibody and 4921 (20%) tested reactive. Just under half of these individuals (49%) had HCV RNA testing, and 1727 (72%) had chronic infection. While reactive antibody was more prevalent in individuals born between 1945 and 1965 (44% vs 17% among those born in other years), most cases (72%) were outside of this birth cohort. With targeted testing using the birth cohort and risk behaviors, the investigators expected up to 35% of positive reactive tests to be missed. Nearly one-quarter (23%) of chronically infected individuals had at least moderate liver fibrosis.
"These data build upon existing evidence supporting the implementation of routine testing for all individuals when entering a correctional facility," Assoumou said in a statement. "Coupled with treatment, routine testing would identify and cure many cases of HCV, preventing the substantial burden of future liver disease."