HCV Screening Before Endoscopy in Hepatogastroenterology Outpatient Clinic: The Depist C Endo Study

Abstract

Systematic screening for hepatitis C virus (HCV) by serology once in a lifetime is recommended by the French Association for the Study of the Liver, but not by the French National Authority for Health. Screening focused on subjects aged over 40 years would seem more appropriate, as the prevalence of hepatitis C increases with age. The aim of this study was to assess the feasibility (number of serologies proposed) and acceptability (number of serologies performed) of HCV screening prior to endoscopy in people aged 40 years and over seen in gastroenterology consultations in non-university hospitals; and to determine whether the prevalence after age 40 is higher than in the general population (0.86%). As of 1 June 2023, 490 patients were included in eight different hospitals in six regions of metropolitan France; 97.4% of patients accepted the prescription of HCV serology and 97.6% of prescribed serologies were performed; 55.5% were men and 44.4% women with a mean age of 58 years (range, 40–90). The HCV serology positivity rate was 6% (29 patients). No previous HCV serology was known. Risk exposures associated with positive HCV serology were drug use in 19 patients, a history of transfusion in six patients and origin from an endemic country in five patients; 90% of positive serologies concerned men and the mean age was 65 years (range, 49–85). Mean hepatic elastometry was 8.7 kPa; 11 out of 28 patients tested had a positive HCV viral load and were treated. Systematic screening for hepatitis C after the age of 40 years and before digestive endoscopy is feasible, well accepted and enables a high number of patients to be managed.