Performance of Risk-Based and Birth-Cohort Strategies for Identifying Hepatitis C Virus Infection Among People Entering Prison, Wisconsin, 2014

Stockman, Lauren J.; Greer, Jim; Holzmacher, Ryan; Dittmann, Beth; Hoftiezer, Scott A.; Alsum, Lori E.; Prieve, Audrey F.; Westergaard, Ryan P.; Guilfoyle, Sheila M.; Vergeront, James M.

doi:10.1177/0033354916662212

Cited by 17 publications

(19 citation statements)

References 15 publications

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“…This disparity has been shown previously, (18) and these estimates suggest racial disparities in hepatitis C have not declined since 2010. Higher prevalence among non-Hispanic blacks compared with persons of other race/ethnicities likely stems from a combination of factors including lower rates of acute hepatitis C clearance, (26)(27)(28) higher rates of incarceration, (29)(30)(31)(32)(33) and less access to effective treatment services. (34)(35)(36) Clinical evidence suggested that interferon-based therapies were less effective for treating genotype 1 HCV infection among non-Hispanic black versus persons of other race/ethnicities, but newer direct-acting antiviral medications provide equally effective treatment across racial groups.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

et al. 2020

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Hepatitis C virus (HCV) infection is a leading cause of liver‐related morbidity and mortality, and more than 2 million adults in the United States are estimated to be currently infected. Reducing HCV burden will require an understanding of demographic disparities and targeted efforts to reduce prevalence in populations with disproportionate disease rates. We modeled state‐level estimates of hepatitis C prevalence among U.S. adults by sex, birth cohort, and race during 2013‐2016. National Health and Nutrition Examination Survey data were used in combination with state‐level HCV‐related and narcotic overdose–related mortality data from the National Vital Statistics System and estimates from external literature review on populations not sampled in the National Health and Nutrition Examination Survey. Nationally, estimated hepatitis C prevalence was 1.3% among males and 0.6% among females (prevalence ratio [PR] = 2.3). Among persons born during 1945 to 1969, prevalence was 1.6% compared with 0.5% among persons born after 1969 (PR = 3.2). Among persons born during 1945 to 1969, prevalence ranged from 0.7% in North Dakota to 3.6% in Oklahoma and 6.8% in the District of Columbia. Among persons born after 1969, prevalence was more than twice as high in Kentucky, New Mexico, Oklahoma, and West Virginia compared with the national average. Hepatitis C prevalence was 1.8% among non‐Hispanic black persons and 0.8% among persons of other races (PR = 2.2), and the magnitude of this disparity varied widely across jurisdictions (PR range: 1.3‐7.8). Overall, 23% of prevalent HCV infections occurred among non‐Hispanic black persons, whereas 12% of the population was represented by this racial group. These estimates provide information on prevalent HCV infections that jurisdictions can use for understanding and monitoring local disease patterns and racial disparities in burden of disease.

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Section: Discussionmentioning

confidence: 99%

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

et al. 2020

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“…While the choice of a screening strategy is highly in uenced by the expected prevalence and budget priorities, evidence on the different HCV screening approaches in low-and middle-income countries is scarce (18,22). In resource-limited settings, risked-based screening is postulated to be of value for case nding among target populations (7,19). However, the reliability of self-reported risk behaviors and the consistency with which the screening criteria are applied have shown to limit the early case detection ability (19,23).…”

Section: Discussionmentioning

confidence: 99%

“…In resource-limited settings, risked-based screening is postulated to be of value for case nding among target populations (7,19). However, the reliability of self-reported risk behaviors and the consistency with which the screening criteria are applied have shown to limit the early case detection ability (19,23). Studies on the e cacy of a risk-based HCV strategy among marginalized populations are limited, and to date, case nding by surveys have been only done in high-income countries (18,19).…”

Section: Discussionmentioning

confidence: 99%

“…However, the reliability of self-reported risk behaviors and the consistency with which the screening criteria are applied have shown to limit the early case detection ability (19,23). Studies on the e cacy of a risk-based HCV strategy among marginalized populations are limited, and to date, case nding by surveys have been only done in high-income countries (18,19). Previous studies have shown bene ts for universal screening in correctional facilities, compared to the risk-based screening, which is in contrast to our ndings (18,24).…”

Section: Discussionmentioning

confidence: 99%

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A simple risk-based strategy for hepatitis C virus screening among incarcerated people in a low- to middle-income setting

Hariri

Sharafkhah

Alavi³

et al. 2020

Preprint

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Background: Hepatitis C virus (HCV) is among the highest priority diseases in custodial settings; however, the diagnosis remains suboptimal among people in custody. This study aimed to validate a short survey for identifying people with HCV infection in a provincial prison in Iran.Methods: Between July and December 2018, residents and newly admitted inmates of Gorgan central prison completed a questionnaire, including data on the history of HCV testing, drug use, injecting drug use, sharing injecting equipment, and imprisonment. Participants received rapid HCV antibody testing, followed by venipuncture for RNA testing (antibody-positive only). Each enrollment question (yes/no) was compared with the testing results (positive/negative).Results: Overall, 1892 people completed the questionnaire, including 621 (34%) who were currently on opioid agonist therapy (OAT); 30% of participants had been tested for HCV previously. About 71% had a history of drug use, of whom 13% had ever injected drugs; 56% had ever shared injecting equipment. Prevalence of HCV antibody and RNA was 6.9% (n=130) and 4.8% (n=90), respectively. The antibody prevalence was higher among people on OAT compared to those with no history of OAT (11.4% vs. 4.0%). History of drug use was the most accurate predictor of having a positive HCV antibody (sensitivity: 95.2%, negative predictive value: 98.9%) and RNA testing (sensitivity: 96.7%, negative predictive value: 99.5%). Sensitivity of the drug use question was lowest among people with no OAT history and new inmates (87% and 89%, respectively). Among all participants, sensitivity and negative predictive value of the other questions were low and ranged from 34% to 54% and 94% to 97%, respectively.Conclusions: In resource-limited settings, HCV screening based on having a history of drug use could replace universal screening in prisons to reduce costs. Developing tailored screening strategies together with further cost studies are crucial to address the current HCV epidemic in low- to middle-income countries.

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“…4,5 The current findings are different from that of a study at the Wisconsin Department of Corrections. 24 The latter found that a targeted approach using history of injection drug use and history of liver disease identified 92% of cases. Using the WADOC data set, a targeted approach including history of drugs use and elevated liver function tests would only identify 58% of cases diagnosed with routine testing.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C Testing and Patient Characteristics in Washington State's Prisons Between 2012 and 2016

Assoumou

Wang

Tasillo

et al. 2019

American Journal of Preventive Medicine

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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 to 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. 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.

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Performance of Risk-Based and Birth-Cohort Strategies for Identifying Hepatitis C Virus Infection Among People Entering Prison, Wisconsin, 2014

Cited by 17 publications

References 15 publications

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

Hepatitis C Virus Prevalence in 50 U.S. States and D.C. by Sex, Birth Cohort, and Race: 2013‐2016

A simple risk-based strategy for hepatitis C virus screening among incarcerated people in a low- to middle-income setting

Hepatitis C Testing and Patient Characteristics in Washington State's Prisons Between 2012 and 2016

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