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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Study: Mid-Missouri overdose patients seldom tested for Hep C

Nathan Lawrence
/
KBIA

A recent analysis from the University of Missouri found that mid-Missourians visiting emergency room for opioid overdoses had high rates of hepatitis C positivity but low rates of being tested for the disease.

Hepatitis C is a blood-borne viral infection that can lead to significant damage to the liver, such as cirrhosis, liver failure and cancer. While it is not vaccine-preventable, it is now treatable.

Individuals who use injection drugs are at a much higher risk of contracting the disease due to behaviors such as needle sharing.

John Swift, a fourth year medical student at MU was the lead on the paper and worked alongside Julie Stilley, Associate Research Professor of Emergency Medicine at MU.

Swift said he was inspired to do this analysis after spending a summer at Johns Hopkins University, where his work included testing everyone coming into the emergency room for HIV and hepatitis C. This is not standard practice at University of Missouri Health Care.

“I have this past experience in the emergency department doing this HIV and hepatitis C screening, and it's proven to be beneficial at other places,” Swift said. “I noticed that it's a potential gap.”

The analysis Swift conducted for MU Health included patients admitted to the emergency room at MU for accidental overdoses from January 2021 to May 2022. Swift then combed through medical records within MU Healthcare from January 2000 to May 2022 for a history of hepatitis C positivity and a record of ever being tested for the disease.

“We found that the burden of hepatitis C within this group was quite high,” Swift said. “It was a minimum of 16.7% of all the people who came in during this time, and that's including all the people who had never had any history of testing that we were aware of. Amongst the people that had tested, 41% had a history of a positive hepatitis C test.”

Swift added the burden of positivity was especially high among men and those aged 55-64, and while the rates of positivity were fairly similar for men and women, men were much less likely to have tested for hepatitis C in the past.

“We don't really think about men as being a group that's disadvantaged, and I think rightfully so,” Swift said. “But this is one of those unique conditions in which there are health disparities amongst men, and this has been shown in other literature, as well, that men have higher rates of hepatitis C than women do.”

Swift said the rate of testing was low for the patients examined; 60% of the patients included in the analysis were never tested for the condition within the University of Missouri healthcare system.

“This is a population that is not getting tested anywhere right now, or at least within our health system,” Swift said. “And if they're not, would the [Emergency Department] be a potential place where we could reach people to do this testing?”

He said testing patients coming into the emergency room for hepatitis C could be a good way to prevent the spread of the disease because it would give patients knowledge they could use to change behaviors, reduce the threat of spread and potentially access treatment - though it is expensive.

“It could help lead to a prevention of asymptomatic spread of people who know their status, at the very least, even if they are not getting treated, having knowledge of this,” Swift said. “Testing as prevention would be a potential benefit from this, for sure, to alter individual actions.”

The current recommendations from the U.S. Preventative Task Force is that all adults, aged 18-to-79 be tested for hepatitis C at least once in their lives.

Testing for hepatitis C can be done for a fee at Columbia/Boone County Health & Human Services.

Rebecca Smith is an award-winning reporter and producer for the KBIA Health & Wealth Desk. Born and raised outside of Rolla, Missouri, she has a passion for diving into often overlooked issues that affect the rural populations of her state – especially stories that broaden people’s perception of “rural” life.