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Epidemiol Infect. 2015 Oct;143(13):2837-40. doi: 10.1017/S0950268815000199. Epub 2015 Feb 12.

High prevalence of hepatitis C (HCV) in the emergency department (ED) of a London hospital: should we be screening for HCV in ED attendees?

Author information

1
Department of Infection and Immunology,The Royal London Hospital,Barts Health NHS Trust,London,UK.
2
Department of Biochemistry,The Royal London Hospital,Barts Health NHS Trust,London,UK.
3
Department of Medical Affairs,Gilead Sciences Ltd,Uxbridge,Middlesex,UK.
4
Blizard Institute of Cell and Molecular Science, Queen Mary University London,London,UK.
5
Department of Virology,The Royal London Hospital,Barts Health NHS Trust,London,UK.

Abstract

An unlinked anonymous study was conducted to estimate the prevalence of hepatitis C virus (HCV) infection in emergency department (ED) attendees at a London Hospital. Nine hundred and ninety-seven samples collected over a 12-day period were tested for HCV antibody (Ab) and reactive samples were further tested for HCV RNA. The HCV seroprevalence was 2·6% (26/997) with 1·2% (12/997) HCV RNA positive. A peak HCV RNA-positive prevalence of 4·8% (3/63) was found in males aged 35-44 years, this was compared to 0% (0/136) in males aged <35 years (P = 0·0614) and 1·4% (4/278) in males aged ⩾45 years (P = 0·2415). Assuming the cost for HCV Ab is £6 and HCV RNA is £40 per test, screening ED attendees aged 25-54 years would cost £360 per viraemic infection and identify 82% of those who were HCV RNA positive, yielding the most favourable cost/benefit ratio. HCV screening of ED attendees aged 25-54 years in this population could be an effective way of identifying patients and limit onward transmission.

KEYWORDS:

Emergency department; HCV RNA-positive prevalence; hepatitis C; screening; seroprevalence

PMID:
25672420
DOI:
10.1017/S0950268815000199
[Indexed for MEDLINE]

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