15 Feb Hepatitis C Screening of Baby-Boomers Still Underutilized
MedicalResearch.com Interview with:
Cheryl Isenhour, DVM, MPH
Epidemiologist |Prevention Branch
Division of Viral Hepatitis | NCHHSTP
Centers for Disease Control and Prevention
MedicalResearch.com: What is the background for this study?
Response: It is estimated that there are over 3 million people in the United States living with Hepatitis C virus (HCV) infection. Risk factors for infection include, but are not limited to, injection drug use, history of incarceration, HIV coinfection, and blood transfusion prior to July 1992. Several direct acting antiviral medications have recently been approved to treat, and in the majority of cases, cure HCV.
The first step in identifying infected persons so that they may be cured of this infection is a blood test for antibodies to HCV.
The greatest burden of HCV is among persons born from 1945 through 1965; the baby boomer birth cohort. Therefore, in 2012, the Centers for Disease Control and Prevention (CDC) published updated HCV antibody testing recommendations to include one-time testing of persons in the birth cohort. The United States Preventive Services Task Force (USPSTF) published similar recommendations the following year. Additionally, in recent years there has been an increase in HCV infections related to injection drug use among younger people.
We used commercial insurance claims data to describe trends in HCV antibody testing over a 10-year period (2005 – 2014), both to assess the impact of the CDC and USPSTF testing recommendations, and to better understanding how trends varied by gender, age group, and geography.
MedicalResearch.com: What are the main findings?
Response: We observed a marked increase in testing among persons in the birth cohort after 2012, to approximately 3% in 2014. Throughout the 10-year study period, the highest HCV testing rates were among persons aged 18 to 39 years, with approximately 4% tested in 2014. Testing was also higher among females compared to males, and those residing in the Middle Atlantic Census Division (New York, New, Jersey, and Pennsylvania).
We also found interesting differences in the diagnosis codes documented at the time of HCV testing. In 2005, codes related to liver disease were most commonly used among persons in the birth cohort, while in 2014 codes related to a general physical examination were most common. This suggests that the primary reasons for testing may have changed following the 2012 testing recommendations. In contrast, diagnosis codes related to sexually transmitted disease screening or exposure history were more commonly used among younger persons who were tested.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings suggest that that the CDC and USPSTF recommendations for one-time testing of persons born from 1945-1965 have positively impacted testing rates since 2012. Unfortunately, among this group of commercially insured individuals, HCV antibody testing remains low overall; highlighting the need to improve testing uptake nationally.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Antibody testing is an important first step in identifying infected persons so they may be linked to recommended HCV care and treatment. While our analysis has shed some light on testing rates and practices among commercially insured persons, it will also be important to assess testing among publicly insured, underinsured, and uninsured populations. Additionally, there are gaps in our understanding of how infected persons progress from HCV antibody testing, to diagnosis, treatment, and cure; the HCV cascade to cure.
No disclosures.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
Hepatitis C Antibody Testing in a Commercially Insured Population, 2005–2014
Cheryl J. Isenhour, DVM, MPH ,Susan H. Hariri, PhD,Craig M. Hales, MD, MPH, MS,Claudia J. Vellozzi, MD, MPH
Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
More Medical Research Interviews on MedicalResearch.com
Last Updated on February 15, 2017 by Marie Benz MD FAAD