Vital Signs: Hepatitis C Treatment Among Insured Adults - United States, 2019-2020.

Introduction: Over 2 million adults in the United States have hepatitis C virus (HCV) infection, and it contributes to approximately 14,000 deaths a year. Eight to 12 weeks of highly effective direct-acting antiviral (DAA) treatment, which can cure ≥95% of cases, is recommended for persons with hepa...

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Publicado en:MMWR: Morbidity & Mortality Weekly Report Vol. 71; no. 32; pp. 1011 - 1018
Autores principales: Thompson, William W., Symum, Hasan, Sandul, Amy, Gupta, Neil, Patel, Priti, Nelson, Noele, Mermin, Jonathan, Wester, Carolyn
Formato: Journal Article
Publicado: Centers for Disease Control & Prevention (CDC) 8/12/2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 8/12/2022
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      pub: Centers for Disease Control & Prevention (CDC)
      place: Atlanta, Georgia
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        atl: Vital Signs: Hepatitis C Treatment Among Insured Adults - United States, 2019-2020.
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          Thompson, William W.
          Symum, Hasan
          Sandul, Amy
          Gupta, Neil
          Patel, Priti
          Nelson, Noele
          Mermin, Jonathan
          Wester, Carolyn
        affil: Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC
      sug:
        subj:
          Hepatitis C Epidemiology
          Hepatitis C, Chronic Epidemiology
          Hepatitis C Drug Therapy
          Hepatitis C, Chronic Drug Therapy
          Aged
          Retrospective Design
          Medicaid
          Hepatitis Viruses
          Vital Signs
          Medicare
          United States
          Adult
          Antiviral Agents Therapeutic Use
          Checklists
          Aged: 65+ years
          Adult: 19-44 years
      ab: Introduction: Over 2 million adults in the United States have hepatitis C virus (HCV) infection, and it contributes to approximately 14,000 deaths a year. Eight to 12 weeks of highly effective direct-acting antiviral (DAA) treatment, which can cure ≥95% of cases, is recommended for persons with hepatitis C.Methods: Data from HealthVerity, an administrative claims and encounters database, were used to construct a cohort of adults aged 18-69 years with HCV infection diagnosed during January 30, 2019-October 31, 2020, who were continuously enrolled in insurance for ≥60 days before and ≥360 days after diagnosis (47,687). Multivariable logistic regression was used to assess the association between initiation of DAA treatment and sex, age, race, payor, and Medicaid restriction status; adjusted odds ratios (aORs) and 95% CIs were calculated.Results: The prevalence of DAA treatment initiation within 360 days of the first positive HCV RNA test result among Medicaid, Medicare, and private insurance recipients was 23%, 28%, and 35%, respectively; among those treated, 75%, 77%, and 84%, respectively, initiated treatment within 180 days of diagnosis. Adjusted odds of treatment initiation were lower among those with Medicaid (aOR = 0.54; 95% CI = 0.51-0.57) and Medicare (aOR = 0.62; 95% CI = 0.56-0.68) than among those with private insurance. After adjusting for insurance type, treatment initiation was lowest among adults aged 18-29 and 30-39 years with Medicaid or private insurance, compared with those aged 50-59 years. Among Medicaid recipients, lower odds of treatment initiation were found among persons in states with Medicaid treatment restrictions (aOR = 0.77; 95% CI = 0.74-0.81) than among those in states without restrictions, and among persons whose race was coded as Black or African American (Black) (aOR = 0.93; 95% CI = 0.88-0.99) or other race (aOR = 0.73; 95% CI = 0.62-0.88) than those whose race was coded as White.Conclusions and Implications For Public Health Practice: 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. Treatment saves lives, prevents transmission, and is cost saving.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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