Using population-level incidence of hepatitis C virus and immigration status for data-driven screening policies: a case study in Israel.
Journal of Public Health, 2020. [Online ahead of print
Leventer-Roberts M, Dagan N, Berent JM, Brufman I, Hoshen M, Braun M, Balicer RD, Feldman BS.
Background: Most studies estimate hepatitis C virus (HCV) disease prevalence from convenience samples. Consequently, screening policies may not include those at the highest risk for a new diagnosis.
Methods: Clalit Health Services members aged 25-74 as of 31 December 2009 were included in the study. Rates of testing and new diagnoses of HCV were calculated, and potential risk groups were examined.
Results: Of the 2 029 501 included members, those aged 45-54 and immigrants had lower rates of testing (12.5% and 15.6%, respectively), higher rates of testing positive (0.8% and 1.1%, respectively), as well as the highest rates of testing positive among tested (6.1% and 6.9%, respectively).
Discussion: In this population-level study, groups more likely to test positive for HCV also had lower rates of testing. Policy makers and clinicians worldwide should consider creating screening policies using on population-based data to maximize the ability to detect and treat incident cases.