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Outcome of screening for hepatitis C virus infection based on risk factors.
Am J Gastroenterol 2008; 103(1):131-7AJ

Abstract

OBJECTIVES

Screening for hepatitis C virus (HCV) infection in individuals at increased risk is currently recommended by most, but not all, health authorities. This study identifies outcomes of individuals diagnosed through a screening program targeting high-risk patients.

METHODS

Veterans presenting for care in VA facilities are assessed for HCV risk factors by a questionnaire. Those with a risk factor are offered anti-HCV testing. Between October 1998 and May 2004, 25,701 patients were assessed and 8,471 patients had a risk factor for HCV. Patients diagnosed through the screening program were assessed per study protocol.

RESULTS

The prevalence of a positive HCV antibody in veterans who identified a risk factor was 7.3% (95% CI 6.6-8.0%). Among those diagnosed through the screening program (N = 260), 47% had chronic hepatitis C. Among patients with chronic HCV, 18% had evidence of advanced liver disease (stage III/IV on biopsy or clinical cirrhosis) while 34% had persistently normal alanine aminotransferase (ALT). Two-thirds of individuals who underwent liver biopsy had minimal or no fibrosis. About half (47%) of the screen-detected patients with chronic HCV were treatment candidates. Forty-four percent were not immediate candidates secondary to medical or psychiatric comorbidities or active substance abuse. Twenty-two patients (8%) had died after a median follow-up of 911 days. Two were liver-related deaths.

CONCLUSION

Screening for hepatitis C in persons at high risk can lead to early identification of individuals at risk for progressive liver disease who may benefit from antiviral therapy and counseling to reduce HCV-related liver injury.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17894850

Citation

Mallette, Carol, et al. "Outcome of Screening for Hepatitis C Virus Infection Based On Risk Factors." The American Journal of Gastroenterology, vol. 103, no. 1, 2008, pp. 131-7.
Mallette C, Flynn MA, Promrat K. Outcome of screening for hepatitis C virus infection based on risk factors. Am J Gastroenterol. 2008;103(1):131-7.
Mallette, C., Flynn, M. A., & Promrat, K. (2008). Outcome of screening for hepatitis C virus infection based on risk factors. The American Journal of Gastroenterology, 103(1), pp. 131-7.
Mallette C, Flynn MA, Promrat K. Outcome of Screening for Hepatitis C Virus Infection Based On Risk Factors. Am J Gastroenterol. 2008;103(1):131-7. PubMed PMID: 17894850.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome of screening for hepatitis C virus infection based on risk factors. AU - Mallette,Carol, AU - Flynn,Maura A, AU - Promrat,Kittichai, Y1 - 2007/09/25/ PY - 2007/9/27/pubmed PY - 2008/3/14/medline PY - 2007/9/27/entrez SP - 131 EP - 7 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 103 IS - 1 N2 - OBJECTIVES: Screening for hepatitis C virus (HCV) infection in individuals at increased risk is currently recommended by most, but not all, health authorities. This study identifies outcomes of individuals diagnosed through a screening program targeting high-risk patients. METHODS: Veterans presenting for care in VA facilities are assessed for HCV risk factors by a questionnaire. Those with a risk factor are offered anti-HCV testing. Between October 1998 and May 2004, 25,701 patients were assessed and 8,471 patients had a risk factor for HCV. Patients diagnosed through the screening program were assessed per study protocol. RESULTS: The prevalence of a positive HCV antibody in veterans who identified a risk factor was 7.3% (95% CI 6.6-8.0%). Among those diagnosed through the screening program (N = 260), 47% had chronic hepatitis C. Among patients with chronic HCV, 18% had evidence of advanced liver disease (stage III/IV on biopsy or clinical cirrhosis) while 34% had persistently normal alanine aminotransferase (ALT). Two-thirds of individuals who underwent liver biopsy had minimal or no fibrosis. About half (47%) of the screen-detected patients with chronic HCV were treatment candidates. Forty-four percent were not immediate candidates secondary to medical or psychiatric comorbidities or active substance abuse. Twenty-two patients (8%) had died after a median follow-up of 911 days. Two were liver-related deaths. CONCLUSION: Screening for hepatitis C in persons at high risk can lead to early identification of individuals at risk for progressive liver disease who may benefit from antiviral therapy and counseling to reduce HCV-related liver injury. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/17894850/Outcome_of_screening_for_hepatitis_C_virus_infection_based_on_risk_factors_ L2 - http://Insights.ovid.com/pubmed?pmid=17894850 DB - PRIME DP - Unbound Medicine ER -