A Screening Program For Hepatitis C Among Baby Boomers In The Northeast United States Has Revealed An Alarmingly High Prevalence Of Hcv Infection Among People Who Inject Drugs

Author: Smith K, Odekon K, Bronson S, Patel P, Tharakan M, Kelly G, Morley E, Marcos L

Theme: Epidemiology & Public Health Research Year: 2018

Background: Hepatitis C virus (HCV) infection affects primarily people born between 1945-1965 [baby boomers (BB)]. Since 2016, Stony Brook University Hospital (SBUH) in Long Island, NY; implemented a routine HCV screening and linkage to care initiative for BB following CDC Guidelines. While a high prevalence of HCV in the BB cohort was observed, a high number of HCV cases among young people who inject drugs (PWID) was also noticed. In 2018, an opioid emergency was declared in the U.S. which dictated our aim to study the prevalence of HCV infection among PWID. Methods: A retrospective study was conducted (January 2016-December 2017) to identify PWID seen in the emergency department (ED) and inpatient from SBUH. Search was performed in the medical records using ICD-10 codes related to illicit drug abuse (F19.10, T40.2X1A, F11, and T40.0-T40.6). Each chart was examined for documented substance abuse to distinguish from patients experiencing adverse effects of prescribed opiates. The chart search function was used to identify illicit substance abuse by the following keywords: heroin, cocaine, IVDA, IVDU, or IV Drug. Results: Out of 1,910 charts having a diagnosis of illicit drug abuse, 1,099 had any substance abuse but only 596 were PWID. Among these PWID, 22% (129/596) were tested for HCV, 49% (63/129) were HCV Ab+ and 64% (40/63), HCV/RNA+. In the same time period (2016-2017), PWID had a higher prevalence rate for HCV than BB (49%vs4%; p˂0.05) and PWID also had a higher rates of RNA+ than BB (43%vs64%; p˂0.05). Conclusion: During our data analysis through HCV FOCUS program, we have found a significantly higher prevalence rate of HCV in PWID than BB at SBUH. Bases on these results, HCV policy was updated at SBUH in 2018 which includes PWID as a targeted population for routine HCV screening in the ED. Disclosure of Interest Statement: The routine screening initiative at Stony Brook Medicine is funded by FOCUS Gilead Sciences.

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