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Indian Health Service increases HCV testing rate fourfold

The Indian Health Service expanded its hepatitis C virus infection testing to the birth cohort 1945 to 1965 after the CDC recommended a one-time HCV testing for this population, which led to a fourfold increase in testing since 2012, according to published findings in Morbidity and Mortality Weekly Report.

“This highlights the outstanding work that Indian Health Service facilities are doing to improve access to life-saving hepatitis C screening and quality medical care,” Susan Karol, MD, FACS, chief medical officer of Indian Health Service, told Healio.com/Hepatology. “The Indian Health Service’s screening rates for American Indian and Alaska Native patients in the birth cohort have more than tripled since the national recommendations were released, greatly increasing the potential for early detection and follow-up for our patients living with hepatitis C infection.”

Susan Karol, MD, FACS 

Taking the CDC’s recommendation into account, as well as the fact American Indian and Alaska Native individuals have a twofold rate of acute HCV incidence and HCV-associated mortality, the Indian Health Service — the principal federal health care advocate and provider for American

Indians and Alaska Natives — implemented HCV testing in individuals born between 1945 and 1965 in 2012 and created a nationally standardized performance measure to monitor this implementation.

The Indian Health Service operates 46 hospitals, 344 health centers, 230 village clinics and health stations in 35 states, according to the report. These facilities are decentralized and therefore the implementation of HCV testing in birth cohort was a local decision based on priorities and capacity.

As of June 2015, the number of individuals in the birth cohort screened for HCV increased from 7.9% to 32.5%. The researchers noted that this increase was associated with provider training and the use of clinical decision tools. Testing rates at the individual institutions ranged from 1.9% to 75.1%; the largest increase in testing was observed in institutions that implemented an electronic clinical decision support tool for testing.

“With this fourfold increase in testing in just 3 years, IHS needs to prepare for the challenges associated with increased identification of persons living with HCV infection,” the researchers wrote.

The researchers concluded: “Identifying persons with HCV infection in American Indian/Alaska Native populations is a priority. Implementation of clinical decision tools should be considered to improve testing and detection; clinical capacity should be adequate to provide the follow-up care and treatment necessary for cure.” – by Melinda Stevens

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