Researchers at the University of Alabama School of Medicine recently published in the journal Hepatology that baby boomers have a higher prevalence of unrecognized chronic hepatitis C virus (HCV) infection. The study is entitled “Unrecognized chronic hepatitis C virus infection among baby boomers in the emergency department.”
The U.S. Preventive Services Task Force and Centers for Disease Control and Prevention (CDC) have emphasized the importance of public screening for the detection of HCV especially in baby boomers, which refers to the individuals born during the post-World War II period, between 1945 and 1965.
HCV infection is, according to the CDC, the most common chronic blood-borne infection in the United States, with around 3.2 million people infected. 60 to 70% of individuals infected with HCV are asymptomatic or experience only mild clinical illness. Chronic HCV infection develops in 70 to 85% of the people who are HCV-positive, and from these 60 to 70% have active liver disease. Most of the infected persons might not be aware of their condition, however, they can be a source of transmission to other individuals and are at risk of developing chronic liver disease or other HCV-related conditions several years or even decades after infection.
Earlier HCV screening was not conducted in babies born in the emergency department. Therefore, in this study, an early experience is described with an integrated opt-out HCV antibody (Ab) screening test applied to medically stable baby boomers in an urban academic emergency department. The prevalence of unrecognized HCV infection was assessed.
Researchers found that of the 2,325 baby boomers analyzed, 12.7% (289) opted out of the HCV screening. HCV Ab tests were then performed on 1,529 individuals, from which 170 (11.1%) tested positive. A follow-up molecular test by polymerase chain reaction was conducted on 150 patients of the HCV Ab-positive group, and 68% (102) of the positive cases were confirmed by detection of viral RNA. The team also found that HCV was more prevalent among males compared to females (14.7% versus 7.4%), African-Americans compared to whites (13.3% versus 8.8%), and for underinsured/uninsured compared to insured patients (16.8/16.9% versus 5%). Of the RNA-positive patients, 54% were successfully contacted by phone, and of these patients, 70.4% (38) scheduled follow-up appointments with liver specialists.
“We observed high prevalence of unrecognized chronic HCV infection in this series of baby boomers presenting to the emergency department, highlighting the emergency department as an important venue for high-impact HCV screening and linkage to care,” concluded the research team.