Better Screening Needed in High Risk HCV Populations

Published on: 

The investigators found having at least 1 risk factor increased the odds of having an HCV-positive result by 20% compared to the population without risk factors.

New research highlights the growing need for better hepatitis C virus (HCV) screening plans in high risk communities.

A team, led by David Kershenobich, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán” identified the risk factors associated to hepatitis C positivity through the evaluation of the epidemiological profile in high risk hepatitis C populations.

“Chronic hepatitis C is considered an important public health challenge,” the authors wrote. “Traditionally identified risk factors have undergone an epidemiological transition where other risk factors have become the main cause of new infections.”

The Study

The cross-sectional study was conducted as part of an ongoing HCV screening program in Mexico, where each participant answered an HCV risk factor questionnaire and took a rapid test.

Each patients reactive to the test were then subject to HCV polymerase chain reaction (PCR) confirmation. The team also used a logistic regression model to examine the associations between HCV infections and the identified risk factors.

Overall, there were 297,631 patients included in the study that completed a risk factor questionnaire and underwent an HCV rapid test.


The results show 4.5% (n = 12,840) were reactive to rapid tests and 3.2% (n = 9257) of participants were confirmed as positives by PCR test.

Looking at this group further, 72.9% had at least 1 of the identified risk factors and 10.8% were in prison. The most common risk factors was a history of acupuncture, tattooing, or piercing, which was found in 21% of participants, as well as intravenous drug use, which was found in 15% of participants and high-risk sexual practices, which was seen in 12%.

After using logistic regressions, the investigators found having at least 1 risk factor increased the odds of having an HCV-positive result by 20% (odds ratio (OR), 1.20; 95% confidence interval [CI], 1.15-1.26), compared to the population without risk factors.

“We identified 3.2% of HCV-viremic subjects, all associated with risk factors and older age. Screening and diagnosis of HCV in high-risk populations (including underserved populations) should be more efficient,” the authors wrote.

Previous Research

Earlier this year, investigators found HCV screenings in community health center settings could be effective in improving rates in largely underserved communities.

A team, led by Brian Chan, MD, MPH, Division of General Internal Medicine and Geriatrics, Addiction Medicine Section, Oregon Health & Science University (OHSU), assessed HCV screening disparities in adults served by community health centers by ethnicity and language preference.

HCV is linked to high morbidity and mortality in the Latin community in the US as chronic liver disease is the leading cause of death within this patient population.

There is a need to implement HCV screening programs in community health center settings to better serve disproportionate percentages of Latinos. Current estimates show Latino have a 6.8 HCV-related deaths per 100,000 compared to 4.5 per 100,000 in non-Hispanic whites.

In the study, Latino-English preferred patients had an overall lower rate of screening compared to both other groups (5.5% vs 9.4% vs 9.6%). Latino-English preferred speakers had lower hazards of HCV screening (adjusted hazard ratio [aHR], 0.56; 95% confidence interval [CI]. 0.44-0.72) compared to non-Hispanic whites, while Latino-Spanish preferred had similar hazards of HCV screening (aHR, 1.11; 95% CI, 0.88-1.41).