Hepatitis C Virus among Patients Visiting a Sexually Transmitted Infections Clinic

Author: Amy Nunn, Michaela Maynard, Danielle Le Brazidec, Alexi Almonte, Philip Chan

Theme: Epidemiology & Public Health Research Year: 2023

Background: Sexually transmitted infection (STI) clinics provide safety-net care for many underserved populations including people who report substance use.  However, optimal practices for hepatitis C virus (HCV) screening in this setting is largely unknown. We evaluated routine versus risk-based screening for HCV in an STI clinic setting. 

Methods: Clinical data on demographics, behaviors and HCV antibody positivity results was reviewed on patients presenting to the major STI Clinic in the state of Rhode Island from 2013-2022. Rhode Island has one of the highest rates of substance use in the United States. We conducted bivariate analyses to explore factors associated with HCV antibody positivity.

Results: During the period of routine-based screening (01/04/2013- 08/12/2015), 3,375 unique patients presented to care, 2,889 (86%) had HCV antibody screening, and 26 (0.90%) had a reactive HCV antibody result. During the period of risk-based screening (08/13/2015-02/10/2022) which was focused on people who reported substance use, 9,779 unique patients presented to care, 3,254 (33%) had HCV antibody screening, and 103 (3.17%) had a reactive HCV antibody result. Risk-based screening was associated with an over 3-fold increase in positivity compared to routine-based screening which was <1%.  HCV antibody positivity among all patients was associated with a history of injection drug use, sharing needles, and exchanging sex for drugs or money. 

Conclusions: Risk-based HCV screening in STI clinic settings may maximize clinical resources. Routine HCV screening could be considered in STI clinic settings with higher rates of baseline HCV infection.

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