title: Comparison of risk-based hepatitis C screening and the true seroprevalence in an urban prison system.
abstract: Hepatitis C virus (HCV) is the most common blood-borne infection in the USA, though seroprevalence is elevated in certain high-risk groups such as inmates. Correctional facility screening protocols vary from universal testing to opt-in risk-based testing. This project assessed the success of a risk-based HCV screening strategy in the Philadelphia Prison System (PPS) by comparing results from current testing practices during 2011-2012 (Risk-Based Screening Group) to a September 2012 blinded seroprevalence study (Philadelphia Department of Public Health (PDPH) Study Cohort). PPS processed 51,562 inmates in 2011-2012; 2,727 were identified as high-risk and screened for HCV, of whom 57 % tested HCV antibody positive. Twelve percent (n = 154) of the 1,289 inmates in the PDPH Study Cohort were anti-HCV positive. Inmates ≥30 years of age had higher rates of seropositivity in both groups. Since only 5.3 % of the prison population was included in the Risk-Based Screening Group, an additional 4,877 HCV-positive inmates are projected to have not been identified in 2011-2012. Gaps in case identification exist when risk-based testing is utilized by PPS. A more comprehensive screening model such as opt-out universal testing should be considered to identify HCV-positive inmates. Identification of these individuals is an important opportunity to aid underserved high-risk populations and to provide medical care and secondary prevention.
authors: Philadelphia Department of Public Health, Division of Disease Control, 500 S. Broad St., Philadelphia, PA, 19146, USA, Danica.kuncio@phila.gov.
authors: Danica E
authors: DE
authors: Kuncio
authors: E Claire
authors: EC
authors: Newbern
authors: Marcelo H
authors: MH
authors: Fernandez-Viña
authors: Bruce
authors: B
authors: Herdman
authors: Caroline C
authors: CC
authors: Johnson
authors: Kendra M
authors: KM
authors: Viner
mesh_terms: D000328:Adult; D000367:Age Factors; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology*; D018937:Hepatitis C Antibodies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015143:Philadelphia; D011330:Prisons / Q000706:statistics & numerical data*; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D014504:Urban Health
chemical_list: D018937:Hepatitis C Antibodies