Performance of Risk-Based and Birth-Cohort Strategies for Identifying Hepatitis C Virus Infection Among People...

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• The prevalence of hepatitis C virus (HCV) infection is increasing among young adults in Wisconsin.
• Prison populations represent a vulnerable group with a high prevalence of HCV infection.

Purpose of the Study:

• To examine the prevalence of HCV infection among male and female inmates entering Wisconsin prisons.
• To evaluate existing and alternative risk-based strategies for identifying HCV infection at intake.

Main Methods:

• HCV testing was integrated into intake procedures for 1,239 adult prison entrants in Wisconsin.
• Risk factors for HCV infection were identified, and the sensitivity and specificity of risk-based testing strategies were calculated.

Main Results:

• The overall prevalence of HCV antibody among prison entrants was 12.5%, with a higher prevalence in the women's facility (21.3%) compared to the men's facility (11.0%).
• Injection drug use, liver disease, and elevated alanine transaminase levels were significant risk factors for HCV infection.
• The Wisconsin Department of Corrections (WDOC) risk-based criteria had 88% sensitivity and 80% specificity.
• Adding the 1945-1965 birth cohort criterion improved sensitivity to 92% while lowering specificity to 71%.

Conclusions:

• The WDOC risk criteria effectively identified 88% of HCV infections among prison entrants.
• Incorporating the 1945-1965 birth cohort into risk-based criteria enhanced HCV testing sensitivity to 92%.
• These findings offer valuable insights for jurisdictions facing resource limitations for universal HCV testing.