Hepatitis C Virus Screening Among Adolescents Attending a Drug Rehabilitation Center

Abstract

Background Hepatitis C virus (HCV) infection has a strong association with intravenous drug use (IVDU). IVDU is a growing public health concern, even in the adolescent population. To our knowledge, there are no published HCV screening studies targeting high-risk adolescents who attend drug rehabilitation centers. This study was designed to determine the seroprevalence of HCV infection utilizing point-of-care (POC) testing at an adolescent drug rehabilitation center and gain a preliminary understanding of the acceptance rate for HCV screening in this high-risk population. Methods This single-center, observational study was conducted at a major drug rehabilitation center in northeast Ohio from July 2016 to June 2017. The consented adolescents who presented at the center were recruited to participate in HCV screening. The participants were administered a survey to assess their demographics and risk behavior profile followed by HCV testing utilizing a POC test. Results During the study period, 150 adolescents were admitted to the drug rehabilitation center, of whom 100 were approached and 85 agreed to participate. Forty percent of the participants (34/85) were females, and 78% (66/85) were white. HCV prevalence among participants was 5% (4/85), all of whom were females. History of heroin use was reported by 15% (13/85) and it was associated with HCV seropositivity; 100% (4/4) of all HCV-positive individuals reported the use of heroin vs only 11% (9/81) of HCV-negative individuals (P = .0004). Conclusions Our study showed a high prevalence of HCV among adolescents attending a drug rehabilitation center with high acceptance of POC HCV testing.

Treatment Coverage and Drug Expenditure in Hepatitis C Patients From 2013 to 2019: A Journey of Improving Treatment Accessibility in Malaysia Through Government-led Initiatives

“…As attention has been disproportionately devoted to patients seeking care from health institutions since DAAs were made available in Malaysia, efforts should also be made to step up the screening and treatment activities at the community level, particularly by extending the services to more public and private primary care centers. Another strategy that could be adopted by the MOH is the micro-elimination approach through systematically screening and treating HCV-infected subpopulations, including patients with advanced liver diseases, prisoners, PWID, PLHIV, hemodialysis patients, and migrants (15)(16)(17). As the first step to make micro-elimination possible, the MOH has recently collaborated with the Ministry of Home Affairs, introducing the hepatitis C program in prisons and drug rehabilitation centers throughout the country.…”

Adolescent Hepatitis C: Prevalence, Impact, and Management Challenges

“… 11 , 12 Most of the pediatric research focuses on high-risk populations: homeless, 13 infected with Human Immunodeficiency Virus (HIV), 11 children that live in endemic regions, 11 and drug rehabilitation centers. 14 A recent modelling study that reviewed worldwide articles published from 2000 to 2019 estimated the prevalence of HCV in children in 249 countries; 0.06% was the estimated current prevalence in the US. 11 This value is a lot lower than what was detected in an American prevalence study conducted with participants from the Third National Health and Nutrition Examination Survey, from 1988 to 1994, in which seropositivity was 0.2% in children 6 to 11 years of age, and 0.4% from 12 to 19.…”

“…6 A small single centered, observational study that screened adolescents in a drug rehabilitation center demonstrated similar results: all the detected HCV cases had a history of IVDU. 14 Non-Hispanic whites, residing in non-urban areas of the USA, comprise most of the young population in which the rise in HCV has been reported. 6 , 9 …”

“… 42 RDTs are also an ideal option to be used in outreach programs that focus on high-risk populations, such as prisons and drug/alcohol treatment centers. 14 , 44 …”

“…60 Some authors, however, recommend testing all adolescents that admit having any type of high-risk behavior because adolescents are less likely to admit to IVDU to parents or primary care physicians. 14 , 31 Others believe that to break the cycle of transmission completely, universal testing of HCV in the answer. 8 …”