Background and objective:
WHO(World Health Organization) aims at eliminating HCV(Hepatitis C Virus) by 2030. To reach the purpose increase testing activity is required in order to reduce undiagnosed fraction . Screening performed in hospital settings and Emergency Department(ED) in particular has the potential to reach large number of individuals, including those with suboptimal access to healthcare services.

Methods:
We searched in PubMed, Scopus and Google Scholar the keyword HCV and screening and hospital. We included articles published between 2013 and 2022 dealing with HCV hospital or ED screening activities in European Countries.

Results:
We found 27 articles across 7 countries. According to two United Kingdom cost-effectiveness studies, HCV screening is cost-effective in high prevalence areas, and is likely to be so in low prevalence areas. Subnational studies focusing on opportunistic screening in ED(n=15) were performed in Belgium,Germany,Ireland,Italy and UK. Included individuals were 15 years or older. The rate of new HCV diagnosis(i.e HCV RNA+ or HCVAg+)ranged from 0.08% to 0.75% in UK Subnational studies focusing on opportunistic screening among hospitalised individuals(n=10) were carried out in Germany, Italy,Poland,Romania. Patients included were aged 0-104 years. In Germany, Italy, Spain studies focused on pre-surgical screening. In Italy, Poland, Romania and Spain studies focused on individuals hospitalised for different reasons, including three studies on SARS-CoV2 patients. New HCV diagnoses rate(i.e HCV RNA+) ranged from 0.02% in Germany to 0.37% in Italy, where new diagnoses represented the 38.59% of the total.

Conclusion:
ED screening resulted cost effectiveness in high prevalence areas. HCV opportunistic screening in hospital settings is effective in identifying previously undiagnosed individuals, including those with suboptimal access to preventive healthcare services. Policy makers could evaluate whether to promote ED screening in order to reduce the undiagnosed fraction