Evaluation of a general practice based hepatitis C virus screening intervention

Area of Science:

• Hepatology
• Public Health
• Infectious Diseases

Background:

• An estimated 37,500 individuals in Scotland had chronic Hepatitis C Virus (HCV) infection in 2003.
• 44% of those infected were undiagnosed former injecting drug users (IDUs), a key group for antiviral therapy.

Purpose of the Study:

• To evaluate the effectiveness of an opportunistic Hepatitis C Virus (HCV) screening intervention within a general practice setting.

Main Methods:

• A comparison of outcome measures between two similar general practices, one with an HCV screening intervention and one without.
• Opportunistic HCV testing and counseling were offered to 30-54 year old attendees at the intervention practice between November 2003 and April 2004.

Main Results:

• HCV test uptake was 28% (117/421) in the intervention practice; no testing occurred in the comparison practice.
• HCV antibody prevalence was 13% overall, but significantly higher in former IDUs (91%) and current IDUs (75%).
• Of 11 HCV RNA positive individuals referred, 9 attended specialist care, and 2 received treatment, with one achieving a sustained viral response.

Conclusions:

• Non-targeted HCV screening in general practice can identify infected former IDUs but has limited yield in non-IDU populations.
• A more targeted approach is recommended for identifying former IDUs.
• Low treatment uptake among chronically infected individuals highlights challenges in clinical management, necessitating strategies to improve access to care, especially for those with a history of problem alcohol use.