Benefits of Screening for HCV Infection Based on Risk Factors
There
is currently wide variation among healthcare providers with regard to screening
patients for hepatitis C. While it is generally
recommended that individuals with risk factors for infection should be screened,
this is not always done in practice.
As reported in the January 2008 American
Journal of Gastroenterology, C. Mallette from Brown University and colleagues
looked at outcomes among individuals diagnosed through a screening program for
veterans presenting for care at Veterans Administration (VA) healthcare facilities
-- a group considered to be at high risk for HCV infection compared with the population
as a whole.
Participants were assessed for HCV risk factors using a questionnaire.
Those with an identified risk factor were offered HCV antibody testing. Between
October 1998 and May 2004, a total of 25,701 patients were assessed, of whom 8471
had a risk factor for HCV.
Results
•
7.3% of veterans who had an identified risk factor tested positive for HCV antibodies.
•
Among the 260 individuals diagnosed through the screening program, 47% had chronic
hepatitis C.
•
Among the patients with chronic HCV, 18% had evidence of advanced liver disease
(stage 3-4 on biopsy or clinical cirrhosis).
•
34% had persistently normal alanine aminotransferase (ALT).
•
Two-thirds of patients who underwent liver biopsy had minimal or no fibrosis.
•
About half (47%) of the patients with chronic HCV detected through screening were
candidates for treatment.
•
44% were not considered candidates for immediate treatment due to medical or psychiatric
co-morbidities or active substance abuse.
•
8% of study participants died after a median follow-up period of 911 days.
•
Out of the 22 total deaths, 2 were liver-related.
Conclusion
Based
on these findings, the authors concluded, "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."
3/07/08
Reference C
Mallette, MA Flynn, and K Promrat. Outcome of Screening for Hepatitis C Virus
Infection Based on Risk Factors. American Journal of Gastroenterology 103(1):
131-137. January 2008.
There
is currently wide variation among healthcare providers with regard to screening
patients for 
Results
