Theme: Epidemiology & Public Health Research Year: 2017
Background: Elimination of HCV is a goal of many public health organizations. It is theoretically possible because of the highly effective pharmacotherapy treatment now available. It cannot be achieved without identifying persons with HCV, of which 50% or more are unaware of their infection, and linking them to qualified healthcare providers. Identification, particularly of young PWIDS, poses special challenges. We report our experience improving such identification through routine (but not mandatory) testing for all PWIDs admitted to an acute detox hospital.
Methods: Princeton House, a behavioral health unit of Princeton Healthcare System, provides in-patient detoxification for opioid use and other substances. Standardized testing for HCV, Hepatitis B and HIV was initiated in October 2014 for PWIDs admitted for acute detox. Testing was strongly encouraged however not automatic and relied on providers to enter orders into the electronic record for it to occur. Over the study period we measured the number of admission for detox, the number of tests performed, and the number positive for HCV antibody. We also tabulated the number of unique cases identified by quarter of observation.
Results: 3076/5625 (54.2%) admitted patients were screened. Effectiveness of screening through the study period increased from 36-72%. Of those tested 1254 (40.8%) were positive (1189 were unique). 2063 (67%) of those tested are < 35 year of age. Unique positive results < 35 were seen in 743 representing 62% of the total positive. Conclusion: Screening is efficient in the care of Hepatitis C in drug detox. We have demonstrated that the use of routine screening will identify many undiagnosed young PWIDS. They represent of a 2nd wave that will prevent us from eliminating HCV. This group must be identified if we are to have any chance of stopping the epidemic.
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