scholarly journals Hepatitis C testing trends among large commercially insured populations, 2011–2017

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Mohammed Khan ◽  
Jae Eui Soh ◽  
William W. Thompson ◽  
Noele P. Nelson
Keyword(s):  
Hepatitis C ◽  
Birth Cohort ◽  
Insurance Coverage ◽  
Outpatient Service ◽  
Antibody Test ◽  
Health Insurance Coverage ◽  
Birth Cohorts ◽  
Antibody Testing ◽  
Testing Rate ◽  
Hcv Antibody

ObjectiveWe estimated the rate of hepatitis C testing between 2011 and 2017 among persons with commercial health insurance coverage and compared rates by birth cohort.IntroductionHepatitis C virus (HCV) infection is the most common blood-borne infection in the US, and a leading cause of liver-related morbidity and mortality. Approximately 3.5 million individuals in the US were estimated to have been living with hepatitis C in 2010, and approximately half of them were unaware that they were infected. Among HCV infected individuals, those born between 1945 and 1965 (usually referred to as the baby boomer cohort) represent approximately 75% of current cases. Because of the substantial burden of disease among this age group, CDC expanded its existing hepatitis C risk-based testing recommendations to include a one-time HCV antibody test for all persons born between 1945 and 1965. The United States Preventive Services Task Force (USPSTF) subsequently made the same recommendation in June 2013.DescriptionWe obtained data from the 2011–2017 IBM MarketScan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases. These data consist of inpatient and outpatient service claims for persons with employer-sponsored health insurance coverage and their dependents. This analysis was restricted to adults 18 years of age and older with continuous enrollment in a commercial or Medicare Supplemental plan for at least one calendar year during the study period (a 45-day gap in coverage was allowed) who received outpatient prescription drug claims data feeds. Claims for hepatitis C antibody testing were identified using Current Procedural Terminology (CPT) codes (80074, 86803). We defined the annual hepatitis C testing rate as the number of patients with an HCV antibody test claim divided by the total number of study-eligible enrollees in a given calendar year. Testing rates were calculated for persons born between 1945 and 1965 and all other adults.There were 54,298,561 unique adults who were continuously enrolled for at least one calendar year during the study period. Among these, 4,629,040 (9%) had one or more inpatient or outpatient service claim with a CPT code for hepatitis C antibody testing during the study period. The overall estimated annual testing rate increased from 2.2% in 2011 to 5.3% in 2017. The testing rate increased from 1.7% to 7.8% among the 1945–1965 birth cohort and 2.5% to 4.0% in other birth cohorts. The average annual percent change in testing was 30.1% among the 1945–1965 birth cohort and 8.2% among other birth cohorts. Testing rate increased markedly (64.1%) between 2016 and 2017 in the 1945–1965 birth cohort, but not in other birth cohorts (7.7%).In this sample of individuals covered by commercial insurance, hepatitis C testing rates have increased slowly between 2011 and 2016. In 2017, there was a substantial increase in testing rates among the Baby Boomer cohort due most likely to an increase in awareness of CDC and USPSTF recommendations by both providers and individual patients associated with CDC health promotion efforts and increased marketing efforts by drug manufacturers. Efforts should continue to promote and increase the awareness of these recommendations and have people tested and treated for HCV.How the Moderator Intends to Engage the Audience in Discussions on the TopicThis panel will discuss strengths and weaknesses for monitoring hepatitis C testing using alternative data sources including self-reported data, insurance claims data, and laboratory testing data. 

scholarly journals Trend analysis in hepatitis C testing, OptumLabs® Data Warehouse, 2011–2017

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Jane Sullivan ◽  
Jae Eui Soh ◽  
Mohammed A. Khan ◽  
William W. Thompson ◽  
Noele P. Nelson
Keyword(s):  
Hepatitis C ◽  
Birth Cohort ◽  
Health Plan ◽  
Task Force ◽  
Antibody Test ◽  
Testing Rate ◽  
The Us ◽  
Hcv Antibody ◽  
Hcv Testing ◽  
Baby Boomer Cohort

ObjectiveUsing administrative claims for privately insured and Medicare Advantage enrollees from a large, private, U.S. health plan, we estimated the prevalence of hepatitis C testing among individuals who were recommended to be tested (i.e., baby boomer cohort born between 1945 and 1965) by the CDC and United States Preventive Services Task Force. This panel will discuss strengths and weaknesses for monitoring hepatitis C testing using alternative data sources including self-reported data, insurance claims data, and laboratory testing data.IntroductionHepatitis C virus (HCV) infection is the most common blood-borne disease in the US and the leading cause of liver-related morbidity and mortality. Approximately 3.5 million individuals in the US were estimated to be living with HCV in 2010 and approximately half of them were unaware that they were currently infected. Among HCV infected individuals, those born between 1945 and 1965 (usually referred to as the baby boomer cohort) represents approximately 75% of current cases. Because of the substantial burden of disease among this age group, CDC expanded its existing HCV risk-based testing recommendations to include a one-time HCV antibody test for all persons born between 1945-1965. The United States Preventive Services Task Force (USPSTF) subsequently made the same recommendation in June 2013.MethodsWe obtained health plan enrollment information and claims data from the 2011 - 2017 OptumLabs® Data Warehouse, and utilized data from patients enrolled in either commercially insured programs or Medicare Advantage. We examined trends in HCV testing for the birth cohort born between 1945 and 1965 and compared their trend in testing to individuals who were not in the birth cohort. We developed two different estimates for HCV testing incidence in order to make comparisons to other commercial claims datasets. The denominator for both estimates was the number of adults continuously enrolled in one or more health plan(s) in a given calendar year (allowing up to a 45-day gap in coverage). The numerator for the first estimate was the number of people receiving any HCV related test in the current calendar year who had not received any HCV related test including HCV antibody test, HCV RNA test or HCV genotype test in the previous calendar years. The numerator for the second estimate was the number of people who were given an HCV antibody test (CPT: 86803 and 80074) in a given calendar year, irrespective of previous testing history.ResultsDuring the study period 2011 - 2017, there were 20,332,848 unique adults who met the inclusion criteria in the OptumLabs® data. Approximately 7.1 million (35.0%) of these individuals were born between 1945 and 1965. On average, there were approximately 2.8 million birth cohort enrollees for any given calendar year. For the birth cohort, the annual incidence of HCV testing was about 2% per year during the time period between 2008 and 2011 (data not shown). In general, between 2011 and 2017, the trends in testing rates were consistent across both estimation methods. Specifically for the birth cohort, the HCV testing rate increased substantially between 2012 and 2017, peaking in 2017 at 8.56% [95% CI: 8.53-8.59%] and 10.24% [95% CI: 10.21-10.27%]. The greatest increase occurred between 2016 and 2017 when the testing rate almost doubled. In contrast, for the non-birth cohort, the HCV testing rate started in 2012 at a rate similar to the birth cohort but did not increase in a similar fashion and did not see a substantial increase in HCV testing in 2016 or 2017.ConclusionsSince CDC and USPSTF recommended universal testing for the birth cohort in 2012 and 2013, respectively, hepatitis C testing rates have been increasing across all age groups. The rate of increase for the birth cohort was substantially greater than that for the non-birth cohort. CDC and USPSTF recommendations are likely a strong contributing factor impacting hepatitis C testing rates in the US. Efforts to promote hepatitis C testing should continue. 

scholarly journals Difficulty of acute hepatitis C diagnosis in a hospitalised patient

2018 ◽  
Vol 11 (1) ◽  
pp. e226907
Author(s):  
Shigemasa Takamizawa ◽  
Toru Yamada ◽  
Koichi Kitamura ◽  
Eiji Hiraoka
Keyword(s):  
Hepatitis C ◽  
Acute Hepatitis ◽  
Chronic Phase ◽  
Antibody Test ◽  
Hcv Infection ◽  
Acute Hepatitis C ◽  
Antibody Testing ◽  
Hcv Antibody ◽  
Hospitalised Patient ◽  
Specific Symptoms

The hepatitis C virus (HCV) causes acute hepatitis C and is commonly detected via HCV antibody testing. However, delayed seroconversion of HCV antibodies and non-specific symptoms may hinder the diagnosis of this disease. A 71-year-old woman developed acute hepatitis while hospitalised for back pain. An HCV antibody test was negative, and she had no risk factors for hepatitis C. She was referred to our hospital for further evaluation. The HCV antibody test was repeated 16 days after the initial test; owing to a positive result, she was diagnosed with acute hepatitis C. Several months thereafter, the HCV spontaneously cleared. When diagnosing an HCV infection, the time at which the testing is performed needs to coincide with the time at which HCV antibody seroconversion occurs. Timely diagnosis of an HCV infection allows appropriate treatment during the acute phase which may prevent disease progression to the chronic phase.

DETEKSI ANTIBODI MULTIPEL HEPATITIS C DALAM DARAH DONOR

2016 ◽  
Vol 21 (3) ◽  
pp. 261
Author(s):  
Ranti Permatasari ◽  
Aryati Aryati ◽  
Budi Arifah
Keyword(s):  
Hepatitis C ◽  
Predictive Value ◽  
Core Protein ◽  
Rapid Test ◽  
Antibody Test ◽  
Diagnostic Value ◽  
Hcv Infection ◽  
Antibody Detection ◽  
Hcv Rna ◽  
Hcv Antibody

Hepatitis C (HCV) infection could be spread by blood transfusion. Screening of HCV in donor blood could prevent HCV infection to the recipient. HCV antibody test using rapid test of multiple antibody detection by immunochromatography method is an easy and rapid test that could detect four HCV antibodies separately. The aim of this study was to evaluate the diagnostic value of antibody HCV using multiple antibody detection rapid test in diagnosing HCV infection. This was an analytical observational study with a cross sectional design. The samples consisted of 42 donors’ blood serum from the Surabaya Branch of the Indonesian Red Cross which underwent HCV infection test using ELISA method. The samples were then tested using PCR HCV RNA as the gold standard and antibody HCV multiple antibodydetection rapid test The diagnostic value of HCV antibody test using multiple antibody detection rapid test by immunochromatography method showed a diagnostic sensitivity of 100%, diagnostic specificity of 75%, positive predictive value of 66.7% and negative predictive value of 100%, a diagnostic efficiency of 83.3%, with a positive probability ratio of 4 times. The most often positive antibody pattern was four (4) positive antibodies (core protein, NS3, NS4 and NS5). Core protein (CP) and NS3 were the most often positive antibodies. Based on this study result, the HCV antibody test using multiple antibody detection rapid test by immunochromatography method has a good diagnostic value.

scholarly journals Rapid point-of-care (POC) testing for Hepatitis C antibodies in a very high prevalence setting: persons injecting drugs in Tallinn, Estonia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anneli Uusküla ◽  
Ave Talu ◽  
Jürgen Rannap ◽  
David M. Barnes ◽  
Don Des Jarlais
Keyword(s):  
Hepatitis C ◽  
Point Of Care ◽  
Antibody Test ◽  
Hcv Rna ◽  
Test Results ◽  
Blood Draw ◽  
Persons Who Inject Drugs ◽  
Oral Swab ◽  
High Prevalence ◽  
Hcv Antibody

Abstract Background Between December 2018 and January of 2019, we evaluated the accuracy of the point-of-care Hepatitis C (HCV) antibody test (POC; OraQuick HCV) used at a community-based needle and syringe exchange program serving persons who inject drugs in Tallinn, Estonia. Methods We compared the results of screening for HCV antibodies by OraQuick (oral swab) and enzyme immunoassay (EIA; blood draw) and assessed test results implications in a high prevalence setting. Findings Of the 100 participants, 88 (88%) had reactive POC test results, and 93 were HCV antibody positive on EIA testing. Sensitivity, specificity and negative predictive value (NPV) for the POC assay with EIA as the relevant reference test were as follows: 94.6% (95% CI 90.0–99.2%), 100% and 58.3% (95% CI 30.4–86.2%). Of the 12 testing, HCV-negative with the POC only 7 (58.3%) were true negatives. Conclusions Oral swab rapid testing HCV screening in this nonclinical setting was sensitive and specific but had unacceptably low NPV. In high prevalence settings, POC tests with high sensitivity and that directly measure HCV RNA may be warranted.

scholarly journals A simple Risk-Based Strategy for Hepatitis C virus Screening Among Incarcerated People in a Low- to Middle-Income Setting

2020 ◽  
Author(s):  
Sanam Hariri ◽  
Maryam Sharafkhah ◽  
Maryam Alavi ◽  
Gholamreza Roshandel ◽  
Abdolreza Fazel ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Use ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Antibody Testing ◽  
Opioid Agonist ◽  
Middle Income ◽  
History Of ◽  
Hcv Antibody

Abstract Background: Hepatitis C virus (HCV) is among the highest priority diseases in custodial settings; however, the diagnosis remains suboptimal among people in custody. This study aimed to validate a short survey for identifying people with HCV infection in a provincial prison in Iran.Methods: Between July and December 2018, residents and newly admitted inmates of Gorgan central prison completed a questionnaire, including data on the history of HCV testing, drug use, injecting drug use, sharing injecting equipment, and imprisonment. Participants received rapid HCV antibody testing, followed by venipuncture for RNA testing (antibody-positive only). Each enrollment question (yes/no) was compared with the testing results (positive/negative).Results: Overall, 1892 people completed the questionnaire, including 621 (34%) who were currently on opioid agonist therapy (OAT); 30% of participants had been tested for HCV previously. About 71% had a history of drug use, of whom 13% had ever injected drugs; 56% had ever shared injecting equipment. Prevalence of HCV antibody and RNA was 6.9% (n=130) and 4.8% (n=90), respectively. The antibody prevalence was higher among people on OAT compared to those with no history of OAT (11.4% vs. 4.0%). History of drug use was the most accurate predictor of having a positive HCV antibody (sensitivity: 95.2%, negative predictive value: 98.9%) and RNA testing (sensitivity: 96.7%, negative predictive value: 99.5%). Sensitivity of the drug use question was lowest among people with no OAT history and new inmates (87% and 89%, respectively). Among all participants, sensitivity and negative predictive value of the other questions were low and ranged from 34% to 54% and 94% to 97%, respectively.Conclusions: In resource-limited settings, HCV screening based on having a history of drug use could replace universal screening in prisons to reduce costs. Developing tailored screening strategies together with further cost studies are crucial to address the current HCV epidemic in low- to middle-income countries.

Test4HepC: Promoting Hepatitis C Testing to Baby Boomers Using Social Media

2019 ◽  
Vol 21 (5) ◽  
pp. 780-790 ◽  
Author(s):  
Aaron Plant ◽  
Emerald G. Snow ◽  
Jorge A. Montoya ◽  
Sean Young ◽  
Marjan Javanbakht ◽  
...  
Keyword(s):  
Social Media ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Qualitative Interviews ◽  
Antibody Test ◽  
The United States ◽  
Perceived Usefulness ◽  
Hcv Antibody ◽  
Hcv Testing ◽  
Test Result

Individuals born between 1945 and 1965 (“baby boomers”) account for an estimated three quarters of all hepatitis C (HCV) infections in the United States. This article describes the evaluation of Test4HepC, a program that uses social media and a website to promote HCV testing to baby boomers in Los Angeles County, California. The first 16 months of Test4HepC were evaluated using an online survey (n = 302), qualitative interviews (n = 20), website and social media analytics, and records of free testing offered though the program. Test4HepC.org had 6,919 visitors; 48 individuals used the free testing offered. Within 1 month of visiting the website, 24.5% (74) of survey participants tested for HCV, 67.6% (50) received a negative HCV antibody test result, 2.7% (2) received a positive HCV antibody test result, and 25.7% (19) had not received their results as of taking the survey. Most of those not tested (60.5%) reported intention to test. In multivariable analysis, male sex and high perceived usefulness of the program website were associated with HCV testing. Qualitative interviews suggested that Test4HepC increased baby boomers’ HCV risk perception and encouraged testing. Social media is a promising strategy for promoting HCV testing to baby boomers. Expanding Test4HepC to other areas and prioritizing the highest risk baby boomers could enable many people with HCV to benefit from new treatments.

Evaluation of hepatitis C antibody testing in saliva specimens collected by two different systems in comparison with HCV antibody and HCV rna in serum

2001 ◽  
Vol 64 (1) ◽  
pp. 13-20 ◽  
Author(s):  
G.J.J. van Doornum ◽  
A. Lodder ◽  
M. Buimer ◽  
E.J.C. van Ameijden ◽  
S. Bruisten
Keyword(s):  
Hepatitis C ◽  
Hcv Rna ◽  
Antibody Testing ◽  
Hcv Antibody

scholarly journals Comparison of Rapid Point-of-Care Tests for Detection of Antibodies to Hepatitis C Virus

2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Dennis G. Fisher ◽  
Kristen L. Hess ◽  
Erlyana Erlyana ◽  
Grace L. Reynolds ◽  
Catherine A. Cummins ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Whole Blood ◽  
Point Of Care ◽  
Antibody Test ◽  
The United States ◽  
Blood Tests ◽  
Hcv Antibody ◽  
Point Of Care Tests

Abstract Background.  Hepatitis C is one of the most prevalent blood-borne diseases in the United States. Despite the benefits of early screening, among 3.2 million Americans who are infected with hepatitis C virus (HCV), 50%–70% are unaware of their infection status. Methods.  Data were collected between 2011 and 2014, from 1048 clients who were in the following groups: (1) injection drug users, (2) women at sexual risk, (3) gay and bisexual men, and (4) transgender individuals. The sensitivity and specificity of point-of-care tests included (1) the MedMira rapid human immunodeficiency virus (HIV)/HCV antibody test, (2) MedMira hepatitis B (HBV)/HIV/HCV antibody test, (3) Chembio HCV Screen Assay used with both whole blood and (4) oral specimens, (5) Chembio HIV-HCV Assay also used with both whole blood and (6) oral specimens, (7) Chembio HIV-HCV-Syphilis Assay, and (8) OraSure HCV Rapid Antibody Test used with whole blood. The gold standard for the HCV tests were HCV enzyme immunoassay (EIA) 2.0. Results.  OraSure had the highest sensitivity at 92.7% (95% confidence interval [CI] = 88.8%–96.5%) followed closely by Chembio's 3 blood tests at 92.1% (95% CI = 87.7%–96.4%), 91.5% (95% CI = 87.2%–95.7%), and 92.3% (95% CI = 88.4%–96.2%). The sensitivities of MedMira HIV/HCV and MedMira HIV/HCV/HBV tests were the lowest, at 79.1% (95% CI = 72.6%–85.5%), and 81.5% (95% CI = 75.2%–87.8%), respectively. Specificity for the OraSure was 99.8% (95% CI = 99.4%–100%); specificity for the Chembio blood tests was 99.2% (95% CI = 98.6%–99.9%), 99.4% (95% CI = 98.8%–99.9%), and 99.3% (95% CI = 98.8%–99.9%); and specificity for the MedMira was100% and 100%. False-negative results were associated with HIV and hepatitis B core antibody serostatus. Conclusions.  The OraSure and Chembio blood tests (including those multiplexed with HIV and syphilis) appear to good performance characteristics. This study has identified potential limitations of rapid testing in those testing positive for HIV and HBcAb. There should be discussion of updates to the 2013 CDC guidance.

scholarly journals Implementation of Birth-Cohort Testing for Hepatitis C Virus

2016 ◽  
Vol 18 (2) ◽  
pp. 283-289 ◽  
Author(s):  
Danielle Liffmann Kruger ◽  
David B. Rein ◽  
Natalie Kil ◽  
Cynthia Jordan ◽  
Kimberly A. Brown ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Electronic Health Record ◽  
Birth Cohort ◽  
Antibody Test ◽  
Health Record ◽  
Technological Support ◽  
Need To Evaluate ◽  
Case Study Report ◽  
Electronic Health

Hepatitis C virus infection affects approximately 2.2 to 3.2 million Americans. In 2012, the Centers for Disease Control and Prevention recommended a one-time antibody test of all persons belonging to the 1945-1965 birth cohort. Efforts to implement this recommendation in clinical settings are in their infancy; this case study report therefore seeks to share the experiences of three sites that implemented interventions to increase birth-cohort testing through participation in the Birth-cohort Evaluation to Advance Screening and Testing for Hepatitis C. At each site, project managers completed standardized questionnaires about their implementation experiences, and a qualitative analysis was conducted of the responses. The testing interventions used in-person recruitment, mail recruitment, and an electronic health record prompt. Sites reported that early efforts to obtain stakeholder buy-in were critical to effectively implement and sustain interventions and that the intervention required additional staffing resources beyond those being used for risk-based testing. In each case, administrative barriers were more extensive than anticipated. For the electronic health record–based intervention, technological support was critical in achieving study goals. Despite these barriers, interventions in all sites were successful in increasing rates of testing and case identification, although future studies will need to evaluate the relative costs and benefits of each intervention.

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