High numbers of hepatitis C infections found at urban ERs

Ten percent of patients tested in a six-month period were infected with the virus, and most had no idea.

By Stephen Feller

WASHINGTON, Aug. 7 (UPI) -- Three-quarters of people who tested positive for the hepatitis C virus in a study of patients at emergency rooms had no idea they were infected with it.

Hepatitis C, a blood-borne infection that can cause liver disease and liver cancer, affects about 3 million people in the United States, about 75 percent of whom are part of the Baby Boom generation.


"In addition to the myriad public health functions they already perform, urban emergency departments may play an important role as safety net providers for HCV screening," said Dr. Douglas White, a researcher and emergency physician at Highland Hospital in Oakland, Calif., in a press release. "We have a better than even chance of reaching many of the three million people who are infected since they tend to be heavy emergency department users already. It gives us a chance to connect these people to ongoing care at HCV clinics or elsewhere in the health care system."

Researchers analyzed patient data on 26,639 adult patients over the age of 18 collected during a six-month study at Highland Hospital in Oakland. Just under 10 percent of those patients, 2,581, completed either virus screening or diagnostic testing as part of program set up in the hospital's emergency room to gauge the prevalence of hepatitis C in the community.


Patients were selected either because they are members of the Baby Boom generation, who are born between 1945 and 1965, or had reported ever using injectible drugs.

Among the group that was tested, 10.3 percent, or 267 people, tested positive for the virus. Researchers classified 70 percent of those as "chronically infected." Only 24 percent of patients were aware they had the virus before being tested at the hospital.

About two-thirds of the patients were not informed of their test results before being discharged from the hospital, requiring staff to track them down -- which researchers said was difficult -- and 76 percent did not show up for follow-up appointments.

"Given skyrocketing rates of injection heroin use around the country, we expect the already high rates of hepatitis C infection to explode," said lead study author Douglas White, MD, of Highland Hospital, Alameda Health System in Oakland, Calif. "Intervention by emergency departments, in the form of screening and referral for treatment, could help slow the spread of this potentially deadly, communicable disease."

The study is published in the Annals of Emergency Medicine.

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