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Abstract Details
Hepatitis C antibody screening and determinants of initial and duplicate screening in the baby boomer patients of six urban primary care clinics
Dagan Coppock1, Edgar Chou2, Edward Gracely3, Robert Gross4, Dong Heun-Lee1
Author information
1Department of Medicine, Division of Infectious Diseases and HIV Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America.
2Department of Medicine, Division of General Internal Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America.
3Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States of America.
4Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
Abstract
Introduction: In 2012, the Centers for Disease Control and Prevention released updated guidelines recommending universal, one-time hepatitis C virus screening for all individuals born between 1945 and 1965. Prior to the implementation of these guidelines, testing rates were inappropriately low, but unnecessary duplicate antibody testing was also problematic. In the era of increased efforts to screen "baby boomers", the prevalence and social determinants of initial and duplicate hepatitis C testing have not been well described.
Methods: A hepatitis C screening program was implemented at six urban primary care clinics affiliated with Drexel University College of Medicine. Data was collected regarding the screening patterns in these clinics. Annual screening rates for the program were assessed. Multivariate logistic regression analyses were used to examine the association of demographic variables and the outcomes of subjects having ever been tested and subjects having received duplicate testing.
Results: Following the implementation of the program, the screening rate increased from 16% in the first year of analysis to 82% in the final year of analysis. Of the 6,717 patients screened, 1,207 had duplicate testing, of which 14% had inappropriate duplicate antibody screening. African Americans and Asian patients had a higher odds of being screened. Patients with public insurance had a higher odds of duplicate screening.
Conclusions: In the setting of an aggressive hepatitis C screening program, high testing rates may be attained in a target population. However, inappropriate duplicate antibody testing rates may be high, which may be a burden in resource-limited settings.