Screening for hepatitis C in an outpatient endoscopy unit

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• The Canadian Liver Foundation recommends hepatitis C (HCV) screening for individuals born between 1945 and 1975.
• Tertiary care hospitals can implement targeted screening during routine outpatient endoscopic procedures.

Purpose of the Study:

• To assess the feasibility and outcomes of birth cohort HCV screening in an outpatient endoscopy setting.
• To evaluate the effectiveness of point-of-care testing and linkage to care for HCV infection.

Main Methods:

• A prospective cohort study involving 912 participants born between 1945-1975 undergoing endoscopy.
• HCV antibody (HCV Ab) testing using OraSure point-of-care test, with HCV RNA confirmation for positive results.
• Linkage to hepatology care for patients with confirmed HCV infection.

Main Results:

• Out of 2,179 eligible patients, 912 consented to screening (49.5% approached).
• HCV antibody positivity was 0.7% (6/912), and HCV RNA positivity was 0.6% (5/912).
• 80% of positive cases were linked to care, with 3 receiving direct-acting antiviral (DAA) therapy and achieving sustained virologic response (SVR).

Conclusions:

• HCV screening in the 1945-1975 birth cohort during endoscopy is feasible and identifies infections.
• High rates of linkage to care and SVR with DAA therapy were observed.
• Strategies to improve patient recruitment and screening reach are necessary for broader implementation.