In the Journals

Gaps in HCV care identified in US

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July 3, 2014

Researchers from the Perelman School of Medicine at the University of Pennsylvania have identified significant gaps in care for individuals with hepatitis C virus infection in the United States, according to new data published in PLOS ONE.

“This study puts forth a good baseline of hepatitis C care in the United States over the last 10 years — which will be useful in monitoring the success and impact of new screening efforts and advances in antiviral therapy,” study researcher Baligh R. Yehia, MD, MPP, MSHP, assistant professor of medicine at Penn, said in a press release. “There are many people who don’t know that they have the infection, don’t have access to hepatitis C care and medications, and who haven’t been treated. With this data, we can see these gaps more clearly. This information will be useful for ensuring better access to hepatitis C care and treatment in the coming years.”

Baligh Yehia, MD, MPP, MSHP 

Baligh R. Yehia

Yehia and colleagues examined data from 10 articles published from January 2003 to July 2013 to provide estimates of the number of people in the United States with HCV infection who completed seven steps in a continuum of care. These included:

  • Infection with chronic HCV;
  • Diagnosis and having an awareness of infection;
  • Access to outpatient care;
  • HCV RNA confirmation testing;
  • Liver fibrosis staging by biopsy;
  • Prescription of HCV treatment; and
  • Achievement of an SVR.

The researchers found that of the 3.5 million people estimated to have chronic HCV in the United States, only 50% (95% CI, 43-57) were diagnosed and aware of their infection status, 43% (95% CI, 40-47) had access to outpatient care; 27% (95% CI, 27-28) had HCV RNA confirmation testing; 17% (95% CI, 16-17) underwent liver fibrosis staging; 16% (95% CI, 15-16) received HCV treatment; and 9% (95% CI, 9-10) had achieved SVR.

According to the researchers, these results underscore the need for improvements in HCV care in the United States, especially in light of new, more effective treatments and increased HCV screening among vulnerable populations, including those born 1945 to 1965 and those at high risk for infection.

Vincent Lo Re III, MD 

Vincent Lo Re III

“The new regimens will be game changers in the treatment of chronic hepatitis C,” study researcher Vincent Lo Re III, MD, MSCE, assistant professor of medicine and epidemiology at Penn, said in the release. “Given the high prevalence of this infection, particularly in baby boomers who didn’t know they were infected, having new, highly effective treatment options to eradicate the virus will be a tremendous benefit to patients that will ultimately help us to reduce liver-related complications and reinfection rates.”

Disclosure: See the study for a full list of financial disclosures.