Fewer than 10% of US residents with chronic hepatitis C virus (HCV) infection know of their illness, have access to health care, and have been treated successfully with antiviral therapy, according to a new study.
The finding comes 2 years after the Centers for Disease Control and Prevention recommended 1-time testing for the baby boom generation born between 1945 and 1965, which accounts for about 75% of all HCV infections in the United States. The study’s lead author, Baligh Yehia, MD, MPP, MSHP, of the University of Pennsylvania Perelman School of Medicine in Philadelphia, said the new data provide a baseline of hepatitis C care that health experts can use to monitor the effect and success of screening such a large population.
Reporting today in the journal PLOS ONE, Yehia and his colleagues conducted a meta-analysis to accurately estimate how many US residents with chronic HCV infection have completed the continuum of care from initial infection and diagnosis to treatment that achieves undetectable viral load. The researchers focused on 10 studies published from 2003 to 2013 from among the 10 000 they screened.
Their analysis showed that in the general US population, an estimated 3.5 million people have chronic HCV infection. About half have been diagnosed and are aware of their illness. Of the entire 3.5 million with chronic infection, some 43% had access to outpatient health care, 27% had their diagnosis confirmed with a hepatitis C virus RNA test, 17% had a liver biopsy to stage their disease, 16% had antiviral treatment prescribed, and about 9% achieved an undetectable viral load.
Last month, the Centers for Medicare & Medicaid Services began reimbursing for hepatitis C virus screening for baby boomers and those in high-risk groups. Six months earlier, the US Food and Drug Administration approved sofosbuvir, an oral medication that in clinical trials produced high rates of sustained viral suppression with fewer adverse effects than current treatments.
“The advent of new antiviral agents for hepatitis C will shorten treatment duration, likely increasing the number of people offered treatment, and improving cure rates,” Yehia said in a statement. “However, educating [health professionals] and the general public about prevention, care, and treatment; ensuring access to skilled treatment of hepatitis C; and addressing the high cost of these agents will be critical to maximizing the benefits of these new therapies.”