Finding Hepatitis C in High-Risk Populations: How New York City Did It

Attention: Medical & Science Editors/Producers

Media Contact: Gregory Bologna
703-299-9766
gbologna@aasld.org
Press Room: November 7 – 11, 2014
Hynes Convention Center, Boston, MA
Telephone: 617-954-2977

Researcher: Mary Ford, MS
Email: mford4@health.nyc.gov
Phone: 347-396-2419

For Immediate Release
Presented: Monday, November 10 2014

It is estimated that 2.4 percent of New York City (NYC) residents have HCV infection, but half do not know their status. To address this gap, the NYC Department of Health and Mental Hygiene launched the Check Hep C Program, which, in its first year, helped increase the rate of complete hepatitis C (HCV) diagnostic testing among at risk populations and has successfully linked more people to HCV supportive services, care, and treatment.

The Check Hep C program funded eight organizations at 12 community sites, including syringe exchange programs and community health centers. Over 4,500 people were screened and tested, and of those who tested HCV RNA positive, 85 percent attended their first medical appointment and 50 percent remained in care, which put them in the position to benefit from the HCV treatment advances of 2014. In describing the Check Hep C program, Mary Ford, MS, program evaluator for the program said, "The screening protocol for the Check Hep C program includes testing those in the birth cohort as well as those who are at high risk from injection drug use either currently or in the past."

After Centers for Disease Control and Prevention (CDC) recommended a one-time screening for HCV infection for all Americans born from 1945 to 1965 (baby boomers), New York State passed a law mandating that health care providers offer a HCV test to individuals in this age group, and provide care or linkage to care for those who test positive. However, many people at high risk for HCV were not visiting a health care provider to get tested or screened.

According to Ms. Ford, "While a formal evaluation of the mandate has not been completed as of yet, we have collected anecdotal evidence from many of our partners and from providers that we have met with during the year, finding that adherence varies widely -- lack of knowledge by primary care providers, lack of accountability by leadership, lack of adequate resources for testing, lack of integration between service delivery locations, etc."

In order to increase screening in groups at highest risk for HCV, the Program generated awareness about HCV and recruited patients through a local media campaign and targeted outreach. The program improved rates of complete diagnosis through field based rapid testing, and confirmation (RNA testing) immediately after HCV antibody positive tests.

In the Check Hep C program population, the estimated prevalence of HCV infection was 14 percent, and 9 percent among persons born after 1965 and 14 percent among baby boomers. Among enrollees, 25 percent had injected drugs in the past (20 times more likely to have HCV infection), 15 percent were homeless (1.6 times more likely to have HCV infection), and 18 percent had been previously incarcerated (5 times more likely to have HCV infection). In addition to supporting the birth cohort based screening recommendation of the CDC, the authors of the article recommend expanding the Check Hep C model to settings with high-risk populations.

"Further outreach and education to primary care providers will be needed to fully implement the testing mandate, and programs like Check Hep C will play an integral role this process in high-risk communities, said Ms. Ford. "The successful model demonstrated in Check Hep C can be replicated not only in community-based organizations, but also in community health centers, and outpatient clinics of large medical centers."
Abstract title:
Check Hep C: A community-based approach to hepatitis C diagnosis in high-risk populations

###

AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD's vision is to prevent and cure liver diseases. This year's Liver Meeting®, held in Boston, November 7-11, will bring together more than 9,000 researchers from 55 countries.

A pressroom will be available from November 7 at the annual meeting. For copies of abstracts and press releases, or to arrange researcher interviews, contact Gregory Bologna at 703-299-9766.

Press releases and all abstracts are available online at www.aasld.org.

Source