A Gap in HCV Screening Recommendations

A significant number of people living with HCV can be found by following the Centers for Disease Control and Prevention (CDC) testing recommendations. These specific guidelines for HCV testing also help with maximizing resources. Something that is becoming more important in areas throughout the U.S. with limited resources. The benefits of universal HCV guidelines and recommendations also come with some draw backs.

A recent research study shows that an increasing number of persons living with HCV may not be getting screened because they fall outside of the testing recommendations.

“Evaluation of the Centers for Disease Control and Prevention Recommendations for Hepatitis C Virus Testing in an Urban Emergency Department”

In this research study, 28% of all HCV positives tests from an emergency room would have been missed by only following birth cohort testing (anyone born between 1945 – 1965).1 The sample size was 924 people and of those 128 were antibody HCV positive. Within the group of 128 antibody HCV positives, 36 would have been missed following current screening guidelines.

The findings from this study are important because they shed light on the fact that emergency room departments (ED) are likely to have higher rates of HCV in populations that reside outside of the current screening recommendations. Having this information gives us the opportunity to change some of our current screening guidelines to try and find more people who are HCV+ and link them to healthcare.

Screening strategies need to be more broad to ensure that everyone who has HCV is given access to medical care and information about their health. Universal screening isn’t cost effective and really doesn’t make sense. However, ignoring the alarming results of studies like the one above also doesn’t make sense. More research needs to be done focusing on ED and HCV rates. Barriers need to be found and addressed that prevent screening in EDs (whether that’s cost, stigma or something else).

The damage done to the liver over time by HCV isn’t our only concern. There are other extra-hepatic manifestations such as skin disease and type 2 diabetes that become more likely the longer someone lives with HCV. These illnesses that develop either directly or indirectly as a result of having HCV have high medical costs associated with them and may prove to be a more significant burden on our health care system than the current wholesale cost of direct acting antivirals that dominant headlines in reference to HCV treatment.

Everyone living with HCV is entitled to a cure. But they can’t receive that cure if they don’t know they are living with HCV.

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