title: Prevalence and risk factors associated with hepatitis C in ED patients.
abstract: The objective of this study was to measure the prevalence of and identify risk factors associated with hepatitis C virus (HCV) in emergency department (ED) patients. Adults presenting to an urban university teaching hospital, having blood drawn as part of their routine evaluation, had an extra tube drawn and tested for HCV. English-speaking adults consenting to participate in the survey portion of the study were administered an in-depth risk factor questionnaire. A case-control analysis was used to identify risk factors in HCV+ compared with HCV- subjects. Contingency table analyses using the Fisher exact test, odds ratios (OR), and 95% confidence intervals (CI) were used for risk factor identification. Of 223 blood samples, 38 (17%) were positive for antibodies for HCV. One hundred twenty-one subjects (54%) agreed to the risk factor survey, 18 (15%) of whom were HCV+. Of the 18 HCV+ survey participants, 12 new diagnoses of HCV were made. A history of injection drug use was the most significant risk factor associated with HCV (OR 858.5, CI 61.8-22,026.5). A high prevalence of HCV is found in selected urban ED patients. Most of these patients have a constellation of risk factors including a history of injection drug use. Efforts to identify at risk patients for serologic testing and follow-up should be initiated. Identifying undiagnosed HCV can lead to interventions to decrease transmission as well as reduce the morbidity and mortality of disease.
authors.affiliation: Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque 87131-5246, USA. jbrillman@salud.unm.edu
authors.forename: Judith C
authors.initials: JC
authors.lastname: Brillman
authors.forename: Cameron S
authors.initials: CS
authors.lastname: Crandall
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Florence
authors.forename: Joshua L
authors.initials: JL
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000635:transmission; D006785:Hospitals, University / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D011159:Population Surveillance; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data; D015206:Southwestern United States / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications; D011795:Surveys and Questionnaires