A Significant Rate of Individuals With Hepatitis C Did Not Initiate Timely Treatment

Approximately one-fourth to one-third of insured individuals diagnosed with a hepatitis C virus (HCV) infection did not initiate treatment within 360 days of diagnosis, according to a new report by the Centers for Disease Control and Prevention (CDC).

In a recent study, the CDC examined the prevalence of direct-acting antiviral (DAA) treatment initiation in individuals diagnosed with hepatitis C in the United States. According to the study, approximately 2.2 million people in the United States had an HCV infection from January 2017 to March 2020.

Using data from HealthVerity, the CDC examined a cohort of adults aged 18 to 69 years (n = 47,687) who were diagnosed with HCV infection who were diagnosed from January 30, 2019, through October 31, 2020. The individuals in the cohort were continuously enrolled in insurance for 60 days or more before diagnosis and 360 days or more after diagnosis.

The researchers found that treatment rates were low among individuals insured with Medicaid (23%), Medicare (28%), and private insurance (35%) within 360 days of the first positive hepatitis C RNA test result. Additionally, among the individuals treated, 75%, 77%, and 84%, respectively, started treatment within 180 days of being diagnosed. Overall, the odds of beginning treatment were lower among Medicaid (aOR = 0.54; 95% CI = 0.51 – 0.57) and Medicare recipients (aOR = 0.62; 95% CI = 0.56 – 0.68) when compared with those with private insurance.

Treatment initiation was lowest among Medicaid recipients aged 18 to 29 years, and individuals aged 30 to 39 years with Medicaid or private insurance when compared with individuals aged 50 to 59 years. Further, lower rates of treatment initiation were reported among individuals with Medicaid who lived in a state with Medicaid treatment restrictions, and among individuals whose race/ethnicity was coded as Black or African American when compared to those coded as White.

To ensure people diagnosed with hepatitis C receive timely treatment, the CDC recommends expanding the number of primary care providers that treat HCV infection and increasing screening, among other steps to improve access.

“Few insured persons with diagnosed hepatitis C receive timely DAA treatment, and disparities in treatment exist. Unrestricted access to timely DAA treatment is critical to reducing viral hepatitis–related mortality, disparities, and transmission,” the researchers concluded. “Treatment saves lives, prevents transmission, and is cost saving.”

—Jessica Ganga

Reference:

Thompson WW, Symum H, Sandul A, et al. Vital signs: hepatitis C treatment among insured adults—United States, 2019-2020. MMWR Morb Mortal Wkly Rep. 2022;71:1011-1017. doi:10.15585/mmwr.mm7132e1.