title: Evaluation of screening criteria to identify persons with hepatitis C virus infection among sexually transmitted disease clinic clients: results from the San Diego Viral Hepatitis Integration Project.
abstract: BACKGROUND
  The Centers for Disease Control and Prevention estimates that 1.8% of the US population is infected with hepatitis C virus (HCV), and most are unaware of their infection.
  
  
  OBJECTIVE
  The goal was to evaluate risk-based HCV screening criteria for clients attending an urban sexually transmitted disease (STD) clinic.
  
  
  METHODS
  This was a cross-sectional study of HCV prevalence among all STD clinic clients during an 8-month period (September 1999 through April 2000) in San Diego, California.
  
  
  RESULTS
  HCV prevalence was 4.9% (165/3367). Clients who reported that they were injecting drug users (IDUs) were much more likely to be HCV-positive than other clients (51% versus 2%; P < 0.001). Selective screening of IDUs, sex partners of IDUs, and persons having received a blood transfusion before 1992 would have identified 70% of HCV-infected clients while screening only 12% of the clinic's attendees. The HCV prevalence among clients with a history of a bacterial STD (in the past 5 years) and no other major risk factors was only 2.5%.
  
  
  CONCLUSIONS
  In STD clinics, integrating risk-based screening into routine clinic services is an efficient way to identify HCV-infected persons.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. robert.gunn@sdcounty.ca.gov
authors.forename: Robert A
authors.initials: RA
authors.lastname: Gunn
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Murray
authors.forename: Carolyn H
authors.initials: CH
authors.lastname: Brennan
authors.forename: David B
authors.initials: DB
authors.lastname: Callahan
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Alter
authors.forename: Harold S
authors.initials: HS
authors.lastname: Margolis
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires