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Nontargeted Screening Approach Better for Identifying New Hep C Infection in ED

By Elana Gotkine HealthDay Reporter

Posted on July 2025

Medically reviewed by Carmen Pope, BPharm. Last updated on July 10, 2025.

THURSDAY, July 10, 2025 -- A nontargeted screening approach in the emergency department is superior to targeted screening for identifying new hepatitis C virus (HCV) infections, according to a study published online July 9 in the Journal of the American Medical Association.

Jason Haukoos, M.D., from Denver Health, and colleagues examined the effectiveness of HCV screening in emergency departments in a prospective, multicenter, pragmatic randomized trial. Patients were randomly assigned to undergo nontargeted screening, in which HCV testing was offered regardless of risk, or targeted screening, in which testing was offered based on risk assessment, as part of routine emergency department care.

A total of 147,498 patient visits were included: 73,847 patients underwent nontargeted screening, resulting in 13.4 percent tested for HCV and 154 new diagnoses, and 73,651 patients underwent targeted screening. Of those who underwent targeted screening, 23,400 had risk factors identified, resulting in 6.3 percent tested and 115 new HCV diagnoses. The researchers found that nontargeted screening identified significantly more new diagnoses of HCV infection compared with targeted HCV screening (relative risk, 1.34). Among those newly diagnosed with HCV, the proportion from nontargeted and targeted screening groups who were linked to follow-up care, initiated direct-acting antiviral (DAA) treatment, completed DAA treatment, and attained sustained virologic response at 12 weeks (SVR12) was small (19.5 versus 24.3 percent; 15.6 versus 17.4 percent; 12.3 versus 12.2 percent; and 9.1 versus 9.6 percent, respectively).

"The substantial decrease in patients who went from diagnosis to SVR12 highlights an urgent need for innovative models of HCV treatment," the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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