title: Implementation of baby boomer hepatitis C screening and linking to care in gastroenterology practices: a multi-center pilot study.
abstract: BACKGROUND
  Estimates suggest that only 20 % of HCV-infected patients have been identified and <10 % treated. However, baby boomers (1945-1965) are identified as having a higher prevalence of HCV which has led the Centers for Disease Control and Prevention to make screening recommendations. The aim of this study was to implement the CDC's screening recommendations in the unique setting of gastroenterology practices in patients previously unscreened for HCV.
  
  
  METHODS
  After obtaining patient informed consent, demographics, clinical and health-related quality of life (HRQOL) data were collected. A blood sample was screened for HCV antibody (HCV AB) using the OraQuick HCV Rapid Antibody Test. HCV AB-positive patients were tested for presence of HCV RNA and, if HCV RNA positive, patients underwent treatment discussions.
  
  
  RESULTS
  We screened 2,000 individuals in 5 gastroenterology centers located close to large metropolitan areas on the East Coast (3 Northeast, 1 Mid-Atlantic and 1 Southeast). Of the screened population, 10 individuals (0.5 %) were HCV AB-positive. HCV RNA testing was performed in 90 % (9/10) of HCV AB-positive individuals. Of those, 44.4 % (4/9) were HCV RNA-positive, and all 4 (100 %) were linked to caregiver. Compared to HCV AB negative subjects, HCV AB-positive individuals tended to be black (20.0 vs. 5.2 %, p = 0.09) and reported significantly higher rates of depression: 60.0 vs. 21.5 %, p = 0.009. These individuals also reported a significantly lower HRQOL citing having more fatigue, poorer concentration, and a decreased level of energy (p < 0.05).
  
  
  CONCLUSIONS
  Although the prevalence of HCV AB-positive was low in previously unscreened subjects screened in the gastroenterology centers, the linkage to care was very high. The sample of patients used in this study may be biased, so further studies are needed to assess the effectiveness of the CDC screening recommendations.
  
  
  CONCLUSIONS
  Implementation of the Baby Boomer Screening for HCV requires identifying screening environement with high prevalence of HCV+ individuals as well as an efficient process of linking them to care.
authors.affiliation: Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA, USA. zobair.younossi@inova.org.|Center for Outcomes Research in Liver Diseases, Washington, DC, USA. zobair.younossi@inova.org.|Betty and Guy Beatty Center for Integrated Research, Claude Moore Health Education and Research Building, 3300 Gallows Road, Falls Church, VA, 22042, USA. zobair.younossi@inova.org.
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
authors.affiliation: Digestive Disease Associates, Wyomissing, PA, USA.
authors.forename: Louis L
authors.initials: LL
authors.lastname: LaLuna
authors.affiliation: AGA Clinical Research Associates, LLC, Egg Harbor Township, NJ, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Santoro
authors.affiliation: GastroHealth, Miami, FL, USA.
authors.forename: Flavia
authors.initials: F
authors.lastname: Mendes
authors.affiliation: Central Bucks Specialists, Gastroenterology, Doylestown, PA, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Araya
authors.affiliation: Digestive Diseases Associates, Catonsville, MD, USA.
authors.forename: Natarajan
authors.initials: N
authors.lastname: Ravendhran
authors.affiliation: Cantara Clinical Solutions, LLC, Morristown, NJ, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Pedicone
authors.affiliation: Cantara Clinical Solutions, LLC, Morristown, NJ, USA.
authors.forename: Idania
authors.initials: I
authors.lastname: Lio
authors.affiliation: Center for Outcomes Research in Liver Diseases, Washington, DC, USA.
authors.forename: Fatema
authors.initials: F
authors.lastname: Nader
authors.affiliation: Center for Outcomes Research in Liver Diseases, Washington, DC, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Hunt
authors.affiliation: Center for Outcomes Research in Liver Diseases, Washington, DC, USA.
authors.forename: Andrei
authors.initials: A
authors.lastname: Racila
authors.affiliation: Center for Outcomes Research in Liver Diseases, Washington, DC, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Stepanova
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002487:Centers for Disease Control and Prevention, U.S.; D003863:Depression / Q000453:epidemiology; D005260:Female; D005762:Gastroenterology; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012367:RNA, Viral / Q000097:blood*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
chemical_list: D018937:Hepatitis C Antibodies; D012367:RNA, Viral