ICYMI: 3 important studies at IDWeek 2018 highlighted gaps in HCV infection prevention efforts among younger adults, ie, born after the baby boomers.
A Closer Look at HCV Screening in the Underserved. While the opioid crisis has been associated with an increase in HCV infections in younger people, little is known about how often individuals with opioid use disorder are being tested at federally qualified health centers. In a retrospective analysis, Dr. Epstein and colleagues sought to characterize HCV screening practices in this setting.
HCV, HIV Screening Poor among Youth at High Risk. HCV testing was done in 2.5% of the overall cohort; of those tested, only ~10% were additionally tested for HIV. Of note, only about 1/3 of individuals with opioid use disorder were tested. That suggests new initiatives are needed to improve rates of HCV-and HIV- screening for at-risk teens and young adults being seen at FQHCs.
Is Risk-based HCV Screening Enough? The opioid epidemic has led to increasing rates of HCV infection that disproportionately affect young white adults in rural areas. Yes while these rates continue to rise, baby boomers are the only cohort of adults universally recommended for HCV screening. The aim of this study was to better characterize HCV infection rates in baby boomers versus younger adults in an area of Kentucky with a high prevalence of IV drug use.
HCV Infection Rate Higher in General Adult Population. Younger adults in this area of Kentucky had significantly higher rates of HCV infections, including 2.9-fold higher odds of antibody positivity and 4.4-fold higher odds of an RNA positive test.
Beyond Baby Boomers. Based on their indings, the investigators recommended increased efforts to target HCV screening in younger cohorts, as well as a reconsideration of the universal screening recommendation to be expanded beyond baby boomers.
The hepatitis C virus cascade of care at Stony Brook University Hospital: Risk factors for linkage to care
Screening, Linkage to Care Disconnect. Investigators in this study looked for factors that might help explain why linkage to HCV care remains inadequate. The conducted a retrospective chart review of patients who received care a tertiary medical center in eastern New York to collect data on demographics, type of insurance, and substance abuse disorder, among other variables.
HCV Infection Linked with High Heroin Use. The HCV positive cases identified were primarily from 3 ZIP codes with the highest prevalence of heroin use.
Mutliple Factors Associated with LTC. Investigators found that having a primary care provider and being a baby boomer were the only two risk factors independently associated with increased odds of linkage to care. Based on that, they suggested that further outreach efforts should be undertaken to increase testing in areas of high prevalence.
Study 1. Epstein RL, Wang J, Mayer K, et al. HCV screening practices among adolescents and young adults in a national sample of federally qualified health centers in the US. Paper presented at: IDWeek 2018, October 2018; San Francisco, CA. Abstract 2570.
Study 2. Rose M, Myers J, Duncan S, Smith M, Espinosa C. Chronic hepatitis C: closing the gap toward eradication – screening young adults vs baby boomers. Paper presented at: IDWeek 2018; October 2018; San Francisco, CA. Abstract 2214.
Study 3. Lier A, Smith K, Bronson B. The hepatitis C virus cascade of care at Stony Brook University Hospital: Risk factors for linkage to care. Paper presented at: IDWeek 2018; October 2018; San Francisco, CA. Abstract 2202.
Three key studies presented at IDWeek 2018 highlighted gaps in HCV infection prevention efforts among younger adults; in case you missed these, check out our slide show summaries of:â Poor rates of HCV screening of adolescents and young adults at federally qualified health centersâ Higher incidence of HCV infection in younger adults versus baby boomers in an area of high IV drug useâ Inadequate linkage to care in younger individuals with HCV infection, many of whom came from areas of high heroin use