Newly available, highly effective treatment options have raised awareness of the need to screen for hepatitis C virus (HCV). However, several recent studies indicate HCV testing strategies are falling short both in reaching all positive cases and in retaining positive patients through confirmatory testing, and ultimately medical referral. Despite national recommendations addressing birth cohort (1945 to 1965) and risk-based HCV screening, it is estimated that more than 50 percent of persons with HCV infection remain unaware of their positive status. Experts say a number of factors contribute to the lack of identification of positive cases including: patients’ lack of disclosure of risk factors, non-complete implementation of birth cohort screening, and risk-based screening strategies that miss cases. Risk-Based Screening Misses Cases Risk-based testing strategies miss cases of HCV-positive prisoners, according to a study published in the Journal of Urban Health. The authors say a more comprehensive screening model, such as opt-out universal testing, should be considered in higher prevalence populations like in correctional facilities (12 to 34 percent HCV antibody positivity rates among prisoners versus 1.6 percent in the overall U.S. population). The Federal Bureau of Prisons recommends HCV testing for all self-reported, high-risk inmates. In actual practice, correctional facility screening […]