Enhanced Detection of Hepatitis C in Emergency Departments Using Nontargeted Screening

Recent research indicates that implementing a nontargeted screening strategy in emergency departments significantly improves the detection rate of newly acquired hepatitis C virus (HCV) infections compared to traditional targeted screening approaches. This study, published online on July 9, 2025, in JAMA, involved a comprehensive evaluation across multiple centers, analyzing the effectiveness of offering HCV testing to all patients regardless of known risk factors.

The study, led by Dr. Jason Haukoos from Denver Health, included 147,498 patient visits. Patients were randomly assigned to either undergo nontargeted screening—where testing was offered broadly—or targeted screening based on risk assessment. Results demonstrated that nontargeted screening identified a higher number of new HCV cases, with 13.4% of the 73,847 patients tested, resulting in 154 new diagnoses. In contrast, targeted screening, applied to patients with identified risk factors, tested 23,400 patients and found 115 new cases. The relative risk of detecting new HCV infections was 1.34 times higher with the nontargeted approach.

However, the follow-through on treatment was less than ideal, with only around 19.5% of newly diagnosed patients from the nontargeted group and 24.3% from the targeted group linked to care and initiating antiviral treatment. The rates of treatment completion and achieving sustained virologic response at 12 weeks remained low across both screening methods, underscoring an urgent need for innovative models to improve linkage to care and treatment adherence.

These findings highlight the potential benefits of broad, nontargeted screening strategies in emergency settings to better identify individuals with active HCV infections. Implementing such approaches could be a crucial step toward controlling and eventually eliminating hepatitis C as a public health threat, especially given the challenges in following up with patients post-diagnosis. Further efforts are required to enhance treatment engagement and achieve higher cure rates.

Source: https://medicalxpress.com/news/2025-07-nontargeted-screening-approach-hep-infection.html