Hepatitis C Patients Get Lost in the Healthcare System

A new study in Hepatology highlights the need to raise awareness among healthcare professionals and at-risk populations about appropriate hepatitis C testing, referral, support, and care.

The authors found that many patients infected with the hepatitis C virus (HCV) feel lost during different stages of healthcare when managing the disease. They assessed the HCV care continuum in Philadelphia from January 2010 to December 2013. Of the 47,207 residents estimated to have HCV, there were positive HCV results for just 13,596 individuals, only 1745 were in care and another 956 had or were currently receiving treatment.

“The inadequacy of screening programs has made it difficult for state health departments to accurately determine the extent of HCV and the rate of transmission within the community,” Kendra Viner, PhD, MPH, from the Philadelphia Department of Public Health, said in a statement. “Our study examines the management of HCV care at a population level to determine which patients tend to fall out of the medical system and why this might occur.”

In the US, approximately 3.2 million people are infected with HCV and up to 70% of those with acute infection have no symptoms and typically don’t even know they have HCV until the disease has progressed into cirrhosis, liver cancer, or liver failure.

Stage 1: HCV Ab screening

Stage 2: HCV Ab and RNA testing

Stage 3: RNA-confirmation and continuing care

Stage 4: RNA confirmation, care, and HCV treatment

The HCV care continuum was defined as:

“Our findings show that many HCV patients are lost at each stage of the healthcare continuum from screening to disease confirmation to care and treatment,” Dr Viner said. “The fact that so few patients with HCV are making it to treatment underscores the need to build awareness among at-risk groups of the importance of screening and continued care. It is critical that public health officials and clinicians understand why patients are lost at each stage so that changes can be made to improve care for those with chronic HCV.”