Tennessee Medicine E-Journal


Background: Estimates show approximately 80,000 persons in Tennessee have Hepatitis C (HCV). In June 2016, the Knox County Health Department became the first public health department to implement universal screening for HCV to address this epidemic. By partnering with Gilead Sciences and Tennessee Department of Health, we obtained funding and created the first local HCV Program in TN.

Objectives: To create a high quality HCV Program, we partnered with clinical services staff, internal and external partners to provide screening, counseling, and linkage to care.

Methods: Universal, opt-out HCV screening was offered in 5 clinics for all persons over 13 years of age. Multiple risk factors were assessed at the time of testing.

Results: Of the 8,224 tested, 68.0% were White with an Ab+ rate of 14.8%, 29.8% African American with an Ab+ rate of 5.2%, and 12.3% Hispanic with an Ab+ rate of 1.5%. Of the Ab+ population, 30.2% were in the 1985-2004 birth cohort (age 13-32), 48.6% 1965-1984 (age 33-52), and 21.2% in the baby boomer cohort 1945-1964 (age 53-72). The baby boomer cohort had the highest within-group Ab+ rate at 23.8% while ages 13-32 and 33-52 had an Ab+ rate of 6.5% and 16.4%, respectively. Within the Ab+ population, 71.1% reported a history of incarceration, 61.3% intranasal drug use, 57.7% injection drug use, and 31.8% homelessness.

Conclusions: Persons testing positive were primarily white, younger than the baby boomer cohort, had a history of incarceration, homelessness and reported intranasal or injection drug use.