Hepatitis C Virus Screening in Federally Qualified Health Centers in Rural Appalachia

Document Type


Publication Date



Purpose of study: This is a descriptive study to ascertain the Hepatitis C Virus (HCV) prevalence and usefulness of screening in medical outreach settings (MO) compared to indigent healthcare clinics (IHC) in northeast Tennessee.

Methods used: Between April 2017 – February 2019, routine, opt-out HCV testing was performed in 4 IHC and 3 MO sites in the Tri-Cities, TN region. During screening, demographic information was collected and the de-identified data were analyzed.

Summary of results: Among 212 clients screened 26 (12.26%) were HCV antibody positive. Of all clients screened 107 (50.47%) were young adults, born after 1965 compared to 99 (46.7%) participants born between 1945-1965. The percentage of HCV antibody cases were 16 (61.54%) and 8(30.77%) for young adults and baby boomers respectively. The percentage of males and females screened were 46.7% and 53.3% respectively, with equal proportion of HCV antibody cases (50%; P=0.7186). Non-Hispanic whites and African Americans made up 90.57% and 9.43% respectively of all clients screened; 96.15% (P=0.2980) of the positive cases were ascribed to non-Hispanic whites. Screening occurred
in seven testing locations, 3 MO events and 4 IHCs. A total of 25 (96.15%; P=0.0056) HCV-antibody positive cases were found in the IHCs compared to 1(3.85%) found in a MO event.

Conclusion: This analysis shows the higher yield of targeted screening at IHCs. Targeted HCV screening is critical in the era of opioid epidemic especially since direct-acting antiviral agents (DAAs) who offer a Sustained Virologic Response (SVR) rate of more than 90% are available.