Pharmacy-based screening program to detect hepatitis C in ‘baby-boomer’ cohorts in western Canada

Author:

Chiew Brandon A1,Fong Anita YP2,Cosgrove Linh T2,Mohajerani Seyed Amir3,Ramji Alnoor3,Lee Samuel S1

Affiliation:

1. Liver Unit, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada

2. London Drugs, 12831 Horseshoe Place, Richmond, British Columbia, Canada

3. Division of Gastroenterology, St Paul’s Hospital, Vancouver, British Columbia, Canada

Abstract

Background: The estimated prevalence of hepatitis C virus (HCV) in Canada is approximately 1.0%. However, the number of individuals living with HCV but unaware of it is estimated to be 30%–44%. Increased screening programs that are accessible, effective, and feasible are important to ensure treatment and meet WHO elimination goals. We implemented an HCV point of care test (POCT) program in community pharmacies to examine the effectiveness and feasibility in screening. Methods: Twenty two London Drugs pharmacies in British Columbia and Alberta implemented an HCV POC screening program using OraQuick rapid antibody tests. Consenting patients filled out a 10-question screening questionnaire to examine risk factors. The participants then were tested using the POCT. While waiting for the test (20 minutes), patients were educated on HCV and treatment options. Results: Three hundred seventy-one participants underwent HCV screening. The most common HCV risk factor was being born between 1945 and 1975 (baby boomer) (93% of cohort), while the second most common was having a tattoo or body piercing (22%). Seven people (2%) tested positive; four were HCV-RNA PCR-positive and were treated, whereas the PCR status of three was unknown as they were lost to follow-up or not tested. Conclusions: Pharmacy-based POCT was shown to be effective and feasible in the western Canadian context, especially for baby boomers. Sustainable funding for pharmacy screening programs may be considered nationwide to identify HCV-infected persons and help meet elimination goals.

Publisher

University of Toronto Press Inc. (UTPress)

Subject

Hepatology

Reference21 articles.

1. National Hepatitis C estimates: Incidence, prevalence, undiagnosed proportion and treatment, Canada, 2019

2. The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver

3. World Health Organization. Global Health Sector Strategies on, respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022-2030.

4. Government of Canada. Hepatitis C virus (HCV): screening and testing for health professionals. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/hepatitis-c-screening-testing-health-professionals.html (accessed December 15, 2022).

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