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Birth cohort screening and linkage to care for HCV treatment still weak in United States
Keith Alcorn, 2016-11-18 08:00:00
Grave weaknesses in hepatitis C screening and linkage to
care are still widespread in the United States and threaten to leave a large
proportion of baby boomers with hepatitis C untreated, presentations at this
week's 2016 AASLD Liver Meeting in Boston showed.
Just 10% of those diagnosed with chronic hepatitis C virus (HCV)
infection at an Atlanta hospital between 2012 and 2014 during routine testing
of the baby boomer generation have since been cured of hepatitis C. The vast
majority of those diagnosed with HCV never progressed beyond a first clinic
visit before being lost to follow-up, one study reported.
A second study, looking at compliance with testing guidelines
in outpatient and primary care settings in Chicago, found that just 15% of baby
boomers presenting for care during a one-month period had been tested for HCV,
despite a US Centers for Disease Control and Prevention (CDC) recommendation that all people born
between 1945 and 1965 should be tested once for HCV antibodies.
And, in New York state, a comprehensive study of testing
activity in the state found that despite a spectacular increase in HCV antibody
testing after passage of a state law mandating birth cohort testing in 2014,
only 6.6% of those eligible were tested in 2014. The New York study also found
that only a third of people who tested positive for HCV subsequently received a
test for HCV RNA to confirm chronic infection and a genotype test in 2014, the
first step in linkage to care for HCV infection.