Hepatitis C virus is the leading indication for liver transplant in the US. Is it time for state-mandated HCV testing?
ACS study finds slight increase in wake of screening recommendation
More baby boomers had been tested for hepatitis C (HCV) two years after a recommendation for universal one-time testing -- but not many more, researchers reported.
The prevalence of HCV testing among people born between 1945 and 1965 was just 12.3% in 2013, when the U.S. Preventive Services Task Force (USPSTF) urged the testing program, according to Ahmedin Jemal, DVM, PhD, and Stacey Fedewa, PhD, both of the American Cancer Society in Atlanta.
Two years later, the prevalence of testing stood at just 13.8%, Jemal and Fedewa reported online in the American Journal of Preventive Medicine.
Testing "did not increase substantially" -- only 10.5 million of 76.2 million baby boomers report ever being tested -- although the difference between 2013 and 2015 reached statistical significance, Jemal and Fedewa concluded.
"These findings underscore the need for increased awareness for HCV testing among healthcare providers and baby boomers and other innovative strategies such as state-mandated HCV testing," they argued.
An estimated 3.5 million people are chronically infected with HCV in the U.S. and 75% of them are baby boomers, according to the CDC. Importantly, because HCV can be without symptoms for years, many of those infected are not aware of the fact.
Chronic HCV can lead to cirrhosis and hepatocellular carcinoma; the disease is the leading indication for liver transplant in the U.S., the CDC says.
The advent of new direct-acting agents against the virus -- drugs that have increased cure rates or shortened the treatment period -- suggests that if more people with chronic HCV were aware of the fact, they might be able to be cured, preventing a host of other liver diseases.
On the other hand, people with chronic HCV face barriers as they try to access the novel therapies, investigators said last summer -- barriers that include cost and restrictions on who can get treatment.
But a key step for potential patients is knowing their HCV status. To examine that issue, Jemal and Fedewa turned to the 2013 and 2015 National Health Interview Surveys, which included 23,967 baby boomers.
The primary outcome was self-reported HCV testing in both years among the 21,827 participants who reported one way or the other.
In 2013, the weighted numbers suggested that some 74,506,656 million boomers were eligible for testing and just 9,144,299 had ever been tested. In 2015, the corresponding numbers were 10,511,639 ever tested from 76,178,472 eligible.
Compared with privately insured people, the researchers found, those on Medicare plus Medicaid, Medicaid only, or military insurance were more likely to report being tested. As well, HCV testing was also more common in men than women, among people who had lived with someone with hepatitis compared with those who had not, and among college graduates compared with people with a high school diploma or less.
The study was supported by the American Cancer Society. Authors are employees of the society.
last updated 03.08.2017
Primary Source: American Journal of Preventive Medicine
Source Reference: Jemal A, et al. Recent hepatitis C virus testing patterns among baby boomers. Am J Prev Med 2017; DOI: 10.1016/j.amepre.2017.01.033.
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