January 12, 2016
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HCV screening rates low among various community health centers

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New research showed that less than 10% of eligible patients across 14 community health centers were screened for hepatitis C virus infection, despite 2013 guidelines from the U.S. Preventive Services Task Force, according to data published in The Journal of the American Osteopathic Association.

“The 2013 release of the [U.S. Preventive Services Task Force] birth cohort screening guidelines for HCV infection recommends a one-time screening for HCV infection for all adults born between 1945 and 1965,” Erica Turse, DO, MPH, of the University of Mississippi Medical Center, and colleagues, wrote. … “The purpose of the present study was to determine the prevalence of HCV infection screening according to the new [U.S. Preventive Services Task Force] birth cohort screening guidelines among a large [community health center] population and to describe screening disparities across demographic characteristics.”

Turse and colleagues analyzed electronic medical records of 60,722 patients with HCV enrolled in a large network database of community health centers. Of the 14 centers included for analysis, eight were from Florida, three from Utah, one from California, one from Kansas and one from New Mexico. All patients were born between January 1, 1945 and December 31, 1965, and visited one of the 14 centers at least once between January 1, 2013 and December 31, 2013.

“HCV screening can reduce health inequities due to undiagnosed, untreated infection,” Turse said in a press release. “Diagnosing this disease is a public health imperative and as an osteopathic physician, I know that swift intervention is the best shot these patients have to avoid cirrhosis, carcinoma and end-stage liver disease.”

Overall, (n = 5,033) 8.3% of patients were screened for HCV. Of these, 48.7% were women (n = 2,450) and 51.3% were men (n = 2,583; P ≤ .01).

“This finding is important because it highlights the need to improve HCV infection screening among patients receiving care in [community health centers], the nation’s primary care safety net,” the researchers wrote.

Patients considered Caribbean Islanders, Haitian or other had a lower predicted probability of being screened for HCV, whereas black Hispanics, white non-Hispanics and black non-Hispanics had the highest predicted probability of being screened (P < .01 for both). Black Hispanic patients were 1.73 times more likely to be screened compared with white Hispanic patients (95% CI, 1.26-2.20). In addition, men were 1.79 times more likely to be screened compared with women (95% CI, 1.30-2.47).

Further analysis showed that as a patient’s age increased by 1 year, the probability of being screened for HCV decreased by 4.2% (95% CI, 3.9-5.2).

“As [community health centers] are the frontline of primary care for populations that may be at increased risk of HCV infection, improving screening rates in [community health centers] can support earlier treatment for patients with HCV infection, which can contribute to reducing the burden of morbidity and mortality caused by the disease.” – by Melinda Stevens

Disclosure: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.