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

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. Goal: The goal was to evaluate risk-based HCV screening criteria for clients attending an urban sexually transmitted disease (STD) clinic. Study Design: 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%. Conclusion: In STD clinics, integrating risk-based screening into routine clinic services is an efficient way to identify HCV-infected persons.