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ABSTRACT: Introduction
There is no widely accepted testing approach for hepatitis C virus infection in correctional settings, and many U.S. prisons do not provide routine testing. The aim of this study was to determine the most effective hepatitis C virus testing strategy in one U.S. state prison and describe the population with reactive testing.Methods
A retrospective analysis was performed using individuals entering the Washington State prison system, which routinely offers hepatitis C virus testing, to compare routine opt-out with current recommendations for risk-based and one-time testing for individuals born between 1945 and 1965. Additionally, liver fibrosis stage was characterized using aspartate aminotransferase to platelet ratio index and Fibrosis-4 index. Analyses were conducted in 2017.Results
Between 2012 and 2016, a total of 24,567 (83%) individuals were tested for the hepatitis C virus antibody and 4,921 (20%) were reactive (test was positive). There were 2,403 (49%) that had hepatitis C virus RNA testing, with 1,727 (72%) showing chronic infection. Reactive antibody was more prevalent in individuals born between 1945 and 1965 compared with other years (44% vs 17%); however, most cases (72%) were outside of this cohort. Up to 35% of positive reactive tests would be missed with testing targeted by birth cohort and risk behavior. Of chronically infected individuals, 23% had at least moderate liver fibrosis.Conclusions
Targeted testing in the Washington State prison system missed a substantial proportion of hepatitis C virus cases; of those with reactive testing, a sizeable proportion of people had at least moderate liver disease, placing them at risk for complications. Routine testing at entry should be considered by U.S. state prisons.
SUBMITTER: Assoumou SA
PROVIDER: S-EPMC6312183 | biostudies-literature | 2019 Jan
REPOSITORIES: biostudies-literature
Assoumou Sabrina A SA Wang Jianing J Tasillo Abriana A Eftekhari Yazdi Golnaz G Tsui Judith I JI Strick Lara L Linas Benjamin P BP
American journal of preventive medicine 20181119 1
<h4>Introduction</h4>There is no widely accepted testing approach for hepatitis C virus infection in correctional settings, and many U.S. prisons do not provide routine testing. The aim of this study was to determine the most effective hepatitis C virus testing strategy in one U.S. state prison and describe the population with reactive testing.<h4>Methods</h4>A retrospective analysis was performed using individuals entering the Washington State prison system, which routinely offers hepatitis C v ...[more]