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The Hepatitis C Virus Cascade of Care at Stony Brook University Hospital: Risk Factors for Linkage to Care (20% linkage to care)
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Reported by Jules Levin
IDWeek 2018, October 3-7, 2018, San Francisco
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WHY are so many saying they are running low on new HCV patients?? Because we are NOT screening at risk populations and we are not linking to care very well & completing the cascade....in addition to these identified - youth & young PWIDs there are many other populations not being tested, thats why they think they are running out of patients. Jules
IDWeek: Only 30% With HCV/HIV in Safety-Net System Get HCV Therapy in DAA Era - Hepatitis C eradication: who is being left behind in the HIV population? - (10/09/18) in a different study at IDWeek youth at Federally Qualified Health Centers only 36% of opioid users were tested for HCV & only 11% for HIV. 9% of the entire population of 269,124 total eligible youth from 13-21 had diagnosed substance abuse disorder which includes opioids, cocaine, cannabis, amphetamine and alcohol. HCV seropositivity was 11% for those with opiod use, 3% for cocaine use & 6% for amphetamine use. Those 13-15 were much less likely to be screened for HCV. Of the 6812 tested for HCV 122 were seropositive, 75% had RNA completed, 42% were RNA+ and only 15 or 37% of those RNA+ had a genotype.
this study reported at INSHU by the same group from Long Island, NY out of Stoney Brook Hospital reports on HCV screening of of individuals with an opiate related hospital visit (n=684) and shows low HCV screening rates: only 22% tested for HCVAb but of those 22% tested 9% were HCVAb+; only 10% (n=71) had HCV RNA of which 40 (6%) were HCVRNA+. Interestingly of the 684 who had an opiate hospital visit 37% were women and 43% were aged 18-29 and of these 42% were female, 35% were aged 30-44, and only 22% were aged 42-52. The authors are highlighting that young drug users may have higher prevalence or incidence in there geographical area which appears to be Suffolk County in Long Island not including Nassau County. In response they updated their HCV testing policy to include PWID in the Emergency Departments including reflex testing from HCVAb to HCV RNA, and HIV rapid test & HBV surface antigen......INSHU: A Screening Program for Hepatitis C among Baby Boomers in the Northeast United States reveals an Alarmingly High Prevalence of HCV among People who Inject Drugs - (10/01/18)
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Audun Lier, MD, MPH1, Kalie Smith, BS2, Silvia Bronson2, Teresa Khoo, MD1, Kerim Odekon, MD1, Ruth Abeles, MD, MS1, Patel, Pruthvi, MD2, Kelly, Gerald, MD1, Tharakan, Mathew MD2, Soliman, Manal2, Fries, Bettina C., MD2, Luis A. Marcos, MD, MPH2
1. Department of Internal Medicine, Stony Brook University Hospital, Stony Brook, NY 2. Division of Infectious Diseases, Stony Brook University Hospital, Stony Brook, NY
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