Demographic profile of potential target populations in community laboratory and emergency department settings for consideration in expanding hepatitis C screening in Aotearoa New Zealand

INTRODUCTION: Elimination of hepatitis C virus (HCV) is possible with publicly funded, highly effective and well-tolerated oral treatment. However, most people with chronic HCV are asymptomatic and remain undiagnosed until complications develop. Furthermore, HCV testing and treatment inequities remain for Māori. The addition of HCV testing to blood sampling for other indications in widely accessed settings to augment current screening strategies warrants further investigation. AIM: We analysed national and regional data to compare attenders at community laboratories and hospital emergency departments (EDs), and Northern Region data from ED attenders to determine the proportion who had blood sampling. METHODS: National data (July 2023-June 2024) and Northern Region data (November 2024) were extracted for people aged ≥20 years. RESULTS: Among 2,586,051 adult attenders at either setting, most (75%) attended community laboratories only, 8% attended EDs only, and 17% attended both (dual attenders). Although Māori represented a higher proportion of ED attenders than community laboratory attenders (22% vs 11%), the number of Māori attenders was 4.4 times greater for community laboratories vs EDs (203,585 vs 46,009). Of community laboratory attenders, 53% (n = 1,013,690) were aged 40-69 years, the age group with the highest HCV prevalence. Among 28,396 ED attenders in the Northern Region, 77% had a blood test at that visit. DISCUSSION: These findings suggest that HCV screening at community laboratories could test more people, including Māori, than screening at EDs. However, the ED setting could capture people who may not engage with other health services, an important group for targeted outreach.