Background: With the emergence of epidemics of Hepatitis C Virus (HCV) infections among young injection drug users (IDUs) in the United States, STD clinics may have a larger role in detecting HCV infections. The purpose of our study was to establish the prevalence of HCV infection among patients seeking care at a metropolitan STD clinic.
Methods: We offered HCV serum antibody testing to patients seeking care at the STD Clinic at the Allegheny County Health Department from August to September 2015. Demographic, medical, and sexual histories were collected and HCV testing was performed via OraQuick HCV Rapid Antibody Test (OraSure Technologies, Inc., Bethlehem, PA). Confirmatory testing was not performed at our institution but patients testing positive were referred for confirmatory testing and subsequent care.
Results: We screened 407 patients for HCV antibodies, and four (1%) patients tested positive. The average age of the four patients with positive HCV antibody tests was 44 years (range 29-59), and 3 were male. All 4 reported a history of incarceration (4/111), and 3/10 reporting IDU tested positive for HCV antibodies. None of the 6 patients with a history of blood transfusion prior to 1992 tested positive. Among 38 patients born in 1965 or earlier, 2 (5%) tested positive. Only 2/228 (0.9%) reporting a past history of an STD tested positive for HCV antibodies. None of the 54 men reporting sex with men were positive for HCV.
Conclusions: The prevalence of HCV antibody-positive clients in our STD Clinic is similar to that in the general U.S. population. The results of this study do not support universal screening of all STD clinic patients. Rather, our data support targeted screening of STD clinic patients using current guidelines for known risk factors (age, incarceration, IDU). As STD clinics are often the sole source of healthcare for at-risk individuals, integration of HCV screening programs in STD clinics is important to detect HCV infections.