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Comparison of risk-based hepatitis C screening and the true seroprevalence in an urban prison system.

Authors:
Danica E Kuncio E Claire Newbern Marcelo H Fernandez-Viña Bruce Herdman Caroline C Johnson Kendra M Viner

J Urban Health 2015 Apr;92(2):379-86

Philadelphia Department of Public Health, Division of Disease Control, 500 S. Broad St., Philadelphia, PA, 19146, USA,

Hepatitis C virus (HCV) is the most common blood-borne infection in the USA, though seroprevalence is elevated in certain high-risk groups such as inmates. Correctional facility screening protocols vary from universal testing to opt-in risk-based testing. This project assessed the success of a risk-based HCV screening strategy in the Philadelphia Prison System (PPS) by comparing results from current testing practices during 2011-2012 (Risk-Based Screening Group) to a September 2012 blinded seroprevalence study (Philadelphia Department of Public Health (PDPH) Study Cohort). PPS processed 51,562 inmates in 2011-2012; 2,727 were identified as high-risk and screened for HCV, of whom 57 % tested HCV antibody positive. Twelve percent (n = 154) of the 1,289 inmates in the PDPH Study Cohort were anti-HCV positive. Inmates ≥30 years of age had higher rates of seropositivity in both groups. Since only 5.3 % of the prison population was included in the Risk-Based Screening Group, an additional 4,877 HCV-positive inmates are projected to have not been identified in 2011-2012. Gaps in case identification exist when risk-based testing is utilized by PPS. A more comprehensive screening model such as opt-out universal testing should be considered to identify HCV-positive inmates. Identification of these individuals is an important opportunity to aid underserved high-risk populations and to provide medical care and secondary prevention.

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http://dx.doi.org/10.1007/s11524-015-9945-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411325PMC
April 2015

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