2214. Chronic Hepatitis C: Closing the Gap Towards Eradication - Screening Young Adults vs. Baby Boomers
Session: Poster Abstract Session: Hepatitis A, B, and C
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Chronic HCV_Closing the Gap Towards Eradication_Pres No. 2214.pdf (164.6 kB)
  • Background:

    Increasing rates of hepatitis C virus (HCV) infection are directly linked to the opioid and intravenous drug (IVD) epidemic. White and rural young adults have been affected disproportionately and most are unaware of their status. However, the CDC recommends HCV screening in persons born between 1945-1965 (baby boomers) with screening on others only based on exposures, behaviors, or comorbid conditions. Increased identification of affected individuals is the first step towards eradication of HCV infection

    Methods:

    A prospective, observational study design was employed. We evaluated data collected between May 2016 to December 2017 from adults seen in the primary care, hospital, and emergency department settings at a large urban-based healthcare organization, located in an area with a high prevalence of intravenous (IV) drug use. Descriptive analyses followed by multivariable logistic regression to identify risk factors associations amongst age groups (1. general adult population, ages 18-52 years; 2. baby boomers ages 53-73 years; and 3. elderly age >74 years) were performed

    Results:

    A total of 59,563 patients were evaluated with a screening antibody. Unadjusted, the general adult population was more likely to have an AB positive screen (7.2% vs. 3.5% and 3.6% respective, p<0.001), be RNA positive (4.9% vs. 1.7% and 1.5% respective, p<0.001), and be Hispanic (3.3% vs. 1.1% and 0.8% respective, p<0.001), while less likely to be a male (16.2% vs. 43.2% and 47.4%, p<0.001). Adjusted (for pregnancy, gender, race and ethnicity) the general adult population is at increased odds of having an RNA positive test (OR=4.4, 95% CI 3.7-5.0, p<0.001) and an AB positive (OR=2.9, 95% CI 2.2-3.9, p<0.001), when compared to baby boomers

    Conclusion:

    Efforts should be targeted to increase screening in younger cohorts as HCV is more prevalent in that group age. In areas affected by the opioid epidemic, revision of policies will decrease the gap towards elimination of HCV and universal screening will help to de-stigmatize this infection. Further, cost-efficiency studies will help inform policy makers of the best strategies to reduce transmission and increase linkage to care as next steps towards closing the gap in elimination of HCV infection

    Michelle Rose, MBA1, John Myers, PhD, MSPH,2, Scott Duncan, MD2, Michael Smith, MD, MSCE3 and Claudia Espinosa, MD, MSC2, (1)Infectious Diseases, Norton Healthcare, Louisville, KY, (2)Pediatrics, University of Louisville, Louisville, KY, (3)Pediatric Infectious Diseases, Duke Univeristy, Durham, NC

    Disclosures:

    M. Rose, Gilead: Project Manager for Grant Funded Research , Norton received a grant from Gilead. The grant covers the salary .

    J. Myers, None

    S. Duncan, None

    M. Smith, None

    C. Espinosa, Gilead: Grant Investigator , Grant recipient . AstraZeneca: Investigator and Speaker's Bureau , Research grant and Speaker honorarium . Cempra: Investigator , Research grant . The Medicines Company/ Melinta Therapeutics: Investigator , Research grant . Regeneron Pharmaceuticals, Inc.: Investigator , Research grant . Merck: Investigator , Research grant . Astellas pharma Europe B.V (APEB): Investigator , Research grant . Cubist pharmaceutical: Investigator , Research grant . Rempex Pharmaceuticals, Inc: Investigator , Research grant . Tetraphase Pharmaceuticals: Investigator , Research grant . Multiple Industry Sponsors: Investigator , Research grant .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.