P005 Hepatitis C screening by country of birth in a genitourinary medicine clinic- How much are we missing?

Background/introduction Screening for Hepatitis C at GUM clinics is recommended by NICE (PH43) in high risk populations. One of these risk groups are people born/brought up in a country with a prevalence >2% of chronic hepatitis C. Aim(s)/objectives To determine the rate of screening by country of birth in GUM clinic attendees before and after the introduction of a clinic specific guideline for Hep C screening. Methods All GUM attendees who were seen between October 2013 and October 2014 and were born in a country of Hep C prevalence of >2% were included. This data was linked to whether a hepatitis C serology test had been performed with the results server. The rate of screening before and after the introduction of guidelines in April 2014 was compared. All HIV positive individuals were excluded. Results During the audit time frame, 2,664 patients were identified as being born in a country with high Hep C prevalence. 1299 attended in the 6 months pre guidelines, 1365 attended 6 months after. Introducing clinic guidelines led to a 2.88 times increase in screening (4.7% vs 13.6%). During this period we diagnosed 3 cases of hepatitis C in people born in a high prevalence country. Discussion/conclusion Introduction of guidelines improved screening in our clinic however the rate of screening remained low. Assuming 2% prevalence we ‘missed’ 50 cases of Hep C. Major factors identified were clinician knowledge of the countries that should be screened and asking the patient their country of birth within the sexual history.