Citation: Journal of Addiction Medicine. 2020 Jul 20.Journal: Journal of addiction medicine.Published: ; 2020ISSN: 1932-0620.Full author list: Smart A; Geboy A; Basch P; Nichols W; Zeymo A; Perez I; Hafeez M; Fleisher I; Fernandez S; Fishbein D.UI/PMID: 32732681.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Health Research Institute | MedStar Washington Hospital Center | MedStar Heart & Vascular InstituteDepartment(s): MedStar Institute for Quality and Safety | Medicine/Infectious DiseasesActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1097/ADM.0000000000000702 (Click here)Abbreviated citation: J Addict Med. 2020 Jul 20.Abstract: OBJECTIVES: CDC reported that 45% of Hepatitis C (HCV) infected people denied known risk factors. Electronic health record RF-based, non-Birth Cohort (born outside of years 1945-1965) screening is challenging as risk factors are often input as nonsearchable data. Testing non-Birth Cohort patients solely based on risk factors has the potential to miss a substantial number of HCV infected patients. The aim was to determine the HCV antibody positive prevalence who would have been missed had providers only followed risk factor based screening recommendations.Abstract: METHODS: A 1:3 case-control retrospective nested chart review was conducted. HCV risk factors and opioid prescriptions were manually abstracted from the Electronic Health Record; other variables were collected using Explorys. In July 2015 HCV screening data was collected on non-Birth Cohort patients who were HCV tested across MedStar Health, as a presumptive marker for high risk. Univariate and multivariate logistic regression models were utilized to determine HCV antibody positive predictors.Abstract: RESULTS: Eighteen (23%) HCV antibody positive and 123 (49%) HCV antibody negative had no identified risk factors; 6 (33%) HCV antibody positive reported risk factors only after a positive test result. There was a significant interaction between age over 40 and opioid prescription use; these groups were 11x more likely to be HCV antibody positive (CI95 1.6-74.8).Abstract: CONCLUSIONS: HCV testing solely based on presence of risk factors in non-Birth Cohort patients has the potential to miss a significant number of HCV antibody positive patients. Given patient- and provider-level barriers in elucidating risk factors, universal HCV antibody screening may be warranted.