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. 2018 Nov;25(11):1397-1400.
doi: 10.1111/jvh.12948. Epub 2018 Jul 3.

Emergency departments at the crossroads of intersecting epidemics (HIV, HCV, injection drug use and opioid overdose)-Estimating HCV incidence in an urban emergency department population

Y-H Hsieh  1 , A V Patel  1 , G S Loevinsohn  1 , D L Thomas  2 , R E Rothman  1   2
Affiliations

Emergency departments at the crossroads of intersecting epidemics (HIV, HCV, injection drug use and opioid overdose)-Estimating HCV incidence in an urban emergency department population

Y-H Hsieh et al. J Viral Hepat. 2018 Nov.

Abstract

High seroprevalence of HCV antibody (anti-HCV) is common among urban emergency department (ED) patients. Little is known regarding incidence of HCV infection in ED patients. We conducted a longitudinal chart-review (2003-2016) of a subset of ED patients between December 2015 and January 2016 (the ‘index period’) in an urban ED that began an ED-based HCV screening program since November 2015. Patients were eligible for inclusion if they presented to the ED during the ‘index period’ and had at least one negative anti-HCV test between 2003 and 2015, and at least one test after the ‘index visit’. Follow-up time (person-years) was calculated for each patient. Incidence ratio (IR) and corresponding 95% CI was used to present the relative incidence between groups.

2% (6/299) patients included had HCV seroconversion during 1706.0 person-years, resulting in an HCV incidence of 3.5/1,000 person-years (95% CI: 1.4, 7.3). Incidence was significantly higher in white patients (IR: 12.9), people who inject drugs (IR: 17.4), and patients with unknown/unaware HIV status (IR: 8.3).

The relatively high HCV incidence in urban ED patients, especially in subgroups disproportionately impacted by opioid use and/or HIV, indicate that EDs represent a critical venue for detecting HCV and should consider prevention services against these intersecting epidemics.

Keywords: CDC recommendations; HCV testing; emergency department; hepatitis C virus; incidence.

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Conflict of interest statement

Declaration of interests

We declare no competing interests.

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