Abstract 2265: HCV seroprevalence and RNA detection rates across Florida, 2015-2018
Authors: Dickey Brittney L. , Coghill Anna E. , Reich Richard R. , Rathwell Julie , Vadaparampil Susan T. , Christy Shannon M. , Roetzheim Richard , Shenkman Elizabeth , Giuliano Anna R. 
Published: June 2022

Chronic hepatitis C virus (HCV) infection is a leading cause of hepatocellular carcinoma in the U.S. While there is no vaccine to prevent HCV, current treatment can cure &gt;90% of infections. About 3 million US residents have been exposed to HCV and 65%-75% remain chronically infected. In response to increasing incidence of HCV infection in younger ages, the US Preventive Services Task Force and the Centers for Disease Control and Prevention (CDC) broadened HCV screening recommendations from baby boomers (born 1945-1965) to all adults aged 18-79 in 2020. Florida has the third highest number of individuals living with HCV in the U.S. (n=151,000). Therefore, our study aimed to identify current high-risk groups that may require advanced HCV screening and targeted HCV management using the OneFlorida Clinical Research Consortium, a state-wide health database representing a diverse set of more than one million individuals for the years 2015-2018. All HCV antibody and viral RNA tests ordered and completed during the study period were used to describe HCV seroprevalence (evidence of current/past HCV infection) and HCV viral load (active infection). Logistic regression was used to determine the odds of HCV seroprevalence or active infection. Analyses were adjusted for sex, race/ethnicity, birth cohort, and HIV status, then stratified by birth cohort and HIV status. Overall, HCV seroprevalence and active infection rates were highest among white/non-Hispanics, males, and baby boomers. However, stratified results revealed distinct risk groups across year and race/ethnicity. Odds of a positive HCV antibody test were higher among Black/non-Hispanic individuals born before 1945 (aOR: 2.74; 95% CI: 1.98-3.78) and 1945-1965 (aOR: 1.46; 95% CI: 1.36-1.56) when compared to white/non-Hispanics. However, in individuals born after 1966, Black/non-Hispanics had lower odds of a positive HCV antibody test (1966-1985, aOR: 0.28; 95% CI: 0.25-0.32; after 1985, aOR: 0.15; 95% CI: 0.13-0.18), with white/non-Hispanics having the highest HCV seroprevalence in younger birth cohorts. The same was observed for HCV active infection. When stratified by HIV status, odds of HCV seroprevalence were highest among baby boomers, regardless of HIV status. However, odds of an active HCV infection across birth cohorts differed by HIV status. Among people living with HIV, active infection was lower in people born after 1985 compared to baby boomers (aOR: 0.45; 95% CI: 0.24-0.86). In contrast, active infection was higher among individuals born after 1985 (aOR: 1.48; 95% CI: 1.28-1.70) for HIV-uninfected individuals in Florida. Patterns of seroprevalence and active HCV infection identified in our study support the recent shift form age and risk based screening guidelines to universal screening. This study provides further guidance to support a strategy for early detection and treatment of HCV to prevent hepatocellular carcinoma among diverse populations.

Citation Format: Brittney L. Dickey, Anna E. Coghill, Richard R. Reich, Julie Rathwell, Susan T. Vadaparampil, Shannon M. Christy, Richard Roetzheim, Elizabeth Shenkman, Anna R. Giuliano. HCV seroprevalence and RNA detection rates across Florida, 2015-2018 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2265.