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Background: Screening for hepatitis C virus (HCV) infection in high risk persons and one-time HCV screening for adults born between 1945 and 1965 is recommended. We provided targeted HCV screening and linkage to care for infected individuals in a public STD clinic, and analyzed these data to identify factors associated with HCV infection in this population.
Methods: The Durham County Department of Public Health received a federal grant to conduct early identification and linkage to care for HCV-infected patients. Targeted HCV screening using HCV antibody and reflex HCV viral load testing was provided to patients in the STD clinic beginning in December 2012. Screening was conducted using these criteria: birth year between 1945 and 1965; HIV-infection; current or past history of injection drug use (IDU); man who has sex with other men; long-term sex partner of HCV-positive person; history of multiple sex partners; and prior incarceration.
Results: To date, 369 patients have undergone targeted HCV screening in the STD clinic in the past 12 months. Fifty-one (14%) were identified with reactive HCV antibodies, of which 37 (10%) had confirmatory HCV RNA results. Among patients with chronic active HCV infection, 25 (68%) were male, 25 (68%) were Black, and 27 (73%) were born between 1945 and 1965. Other predominant risk factors among patients with chronic active HCV infection included current or past IDU (68%) and prior incarceration (65%). None of the patients with HCV had HIV co-infection. Despite use of an HCV Bridge Counselor to follow-up with HCV-infected patients, only 10 (27%) patients with chronic active HCV infection have been linked to care; barriers include accessibility to an HCV provider and transportation.
Conclusions: A targeted HCV screening program in an STD clinic can identify a significant proportion of patients with chronic active HCV infection, but additional measures are needed to facilitate linkage to care.