Evaluation of three testing strategies for defection of hepatitis C in a hospital medical consultation and in an HIV testing center

Aims - Testing for hepatitis C virus (HCV) is recommended. The purpose of t his study was to evaluate the efficacy of HCV testing in a medical consulta tion without an appointment and in an HIV testing center based on three tes ting strategies: 1997 French Consensus Conference, "Lettre de la Direction Generale de la Sante" (January 1996), and extension to other risk factors. Patients and methods - For 6 months a free blood test was offered to any pa tient with a risk factor according to the literature. Results - There were 1736 new patients at the medical consultation and 1616 at the testing center. The patients were younger at the testing center tha n at the medical consultation (31.1 vs 43.3 years; P < 0.001). Acceptance o f screening was better at the testing center (97.8% vs 75.2%; P < 0.001). T here were more patients exposed to one of the risk factors at the testing c enter (31.2% vs 13.9%; P < 0.001). Tests were more efficient at the testing center. 30 HCV positive patients/1 616 (1.86%) vs 11/1 736 (0.63%, P < 0.0 1). Tests based on the 1997 French Consensus Conference provided detection in 27/30 (90%) of HCV positive patients at the testing center but only 4/11 (36.3%) at the medical consultation (P < 0.01). Conclusion - Testing was effective in both places but was more efficient at the testing center. Efficacy of the testing strategies differs significant ly according to the place of screening. At the testing center, screening ca n be restricted to patients with a history of intravenous drug use and bloo d transfusion. At the medical consultation, screening should be extended to other risk factors.