title: Hepatitis C virus infection in the 1945-1965 birth cohort (baby boomers) in a large urban ED.
abstract: BACKGROUND
  The US Preventive Services Task Force recommends one-time screening of the 1945-1965 birth cohort (baby boomers) for hepatitis C (HCV) infection. New York State legislation mandates screening of baby boomers for HCV in most patient care settings except the emergency department (ED). This cross-sectional study explores baby boomer knowledge of HCV, prevalence of HCV infection, and linkage to care from a large urban ED.
  
  
  METHODS
  Patients participated in a researcher-administered structured interview and were offered an HCV screening test. If HCV antibody reactive, a follow-up clinic appointment was made within 6 weeks. Reminder telephone calls were made a week before the appointment. Attendance at the follow-up appointment was considered successful linkage to care.
  
  
  RESULTS
  A total of 915 eligible patients were approached between October 21, 2014, and July 13, 2015. A total of 427 patients participated in the structured interview; 383 agreed to an HCV rapid test. Prevalence of HCV antibody reactivity was 7.3%. Four patients were successfully linked to care. General knowledge about HCV was fair. Misconceptions about transmission were apparent. Beliefs that "if someone is infected with HCV they will most likely carry the virus all their lives unless treated" and that "someone with hepatitis can look and feel fine" were significantly associated with agreement to testing.
  
  
  CONCLUSIONS
  Better linkage to care is needed to justify HCV screening in the 1945-1965 birth cohort in this particular ED setting. Linkage to care from the ED is challenging but can potentially be improved with specific measures including simplified screening algorithms and supportive resources.
authors.affiliation: Department of Medicine, Division of Infectious Diseases and Immunology, New York University School of Medicine, New York, NY 10016. Electronic address: allison.wari@gmail.com.
authors.forename: Waridibo E
authors.initials: WE
authors.lastname: Allison
authors.affiliation: Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY 10016.
authors.forename: William
authors.initials: W
authors.lastname: Chiang
authors.affiliation: Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY 10016.
authors.forename: Ada
authors.initials: A
authors.lastname: Rubin
authors.affiliation: Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY 10016.
authors.forename: Lauren
authors.initials: L
authors.lastname: O'Donnell
authors.affiliation: Department of Medicine, New York University School of Medicine, New York, NY 10016.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Saldivar
authors.affiliation: Department of Medicine, Division of Infectious Diseases and Immunology, New York University School of Medicine, New York, NY 10016.
authors.forename: Michael
authors.initials: M
authors.lastname: Maurantonio
authors.affiliation: Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY 10016.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Dela Cruz
authors.affiliation: Department of Medicine, Division of Infectious Diseases and Immunology, New York University School of Medicine, New York, NY 10016.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Duvidovich
authors.affiliation: Department of Medicine, Division of Infectious Diseases and Immunology, New York University School of Medicine, New York, NY 10016.
authors.forename: Ellie
authors.initials: E
authors.lastname: Carmody
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D016174:Hepacivirus / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012017:Referral and Consultation; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D000914:Antibodies, Viral