TY - JOUR
T1 - Check Hep C
T2 - A Community-Based Approach to Hepatitis C Diagnosis and Linkage to Care in High-Risk Populations
AU - Ford, Mary M.
AU - Jordan, Ashly E.
AU - Johnson, Nirah
AU - Rude, Eric
AU - Laraque, Fabienne
AU - Varma, Jay K.
AU - Hagan, Holly
N1 - Publisher Copyright:
Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc.
PY - 2018
Y1 - 2018
N2 - Context: In New York City (NYC), an estimated 146 500 people, or 2.4% of the adult population, have chronic hepatitis C virus (HCV) infection and half may be unaware of their infection. Despite a 2014 state law requiring health care providers to screen for HCV infection in primary care settings, many high-risk HCV-positive persons are not, and a large proportion of those screened do not receive RNA testing to confirm infection, or antiviral therapies. Objective: The NYC Department of Health's Check Hep C program was designed to increase hepatitis C diagnosis and improve linkage to care at community-based organizations. Design: Coordinated, evidence-based practices were implemented at 12 sites, including HCV antibody testing, immediate blood draw for RNA testing, and patient navigation to clinical services. Results: From May 2012 through April 2013, a total of 4751 individuals were tested for HCV infection and 880 (19%) were antibody-positive. Of antibody-positive participants, 678 (77%) had an RNA test, and of those, 512 (76%) had current infection. Of all participants, 1901 were born between 1945 and 1965, and of those, 201 (11%) were RNA-positive. Ever having injected drugs was the strongest risk factor for HCV infection (40% vs 3%; adjusted odds ratio [AOR] = 19.1), followed by a history of incarceration (18% vs 4%; AOR = 2.2). Of the participants with current infection, 85% attended at least 1 follow-up hepatitis C medical appointment. Fourteen patients initiated hepatitis C treatment at a Check Hep C site and 6 initiators achieved cure. Conclusion: The community-based model successfully identified persons with HCV infection and linked a large proportion to care. The small number of patients initiating hepatitis C treatment in the program identified the need for patient navigation in high-risk populations. Results can be used to inform screening and linkage-to-care strategies and to support the execution of hepatitis C screening recommendations.
AB - Context: In New York City (NYC), an estimated 146 500 people, or 2.4% of the adult population, have chronic hepatitis C virus (HCV) infection and half may be unaware of their infection. Despite a 2014 state law requiring health care providers to screen for HCV infection in primary care settings, many high-risk HCV-positive persons are not, and a large proportion of those screened do not receive RNA testing to confirm infection, or antiviral therapies. Objective: The NYC Department of Health's Check Hep C program was designed to increase hepatitis C diagnosis and improve linkage to care at community-based organizations. Design: Coordinated, evidence-based practices were implemented at 12 sites, including HCV antibody testing, immediate blood draw for RNA testing, and patient navigation to clinical services. Results: From May 2012 through April 2013, a total of 4751 individuals were tested for HCV infection and 880 (19%) were antibody-positive. Of antibody-positive participants, 678 (77%) had an RNA test, and of those, 512 (76%) had current infection. Of all participants, 1901 were born between 1945 and 1965, and of those, 201 (11%) were RNA-positive. Ever having injected drugs was the strongest risk factor for HCV infection (40% vs 3%; adjusted odds ratio [AOR] = 19.1), followed by a history of incarceration (18% vs 4%; AOR = 2.2). Of the participants with current infection, 85% attended at least 1 follow-up hepatitis C medical appointment. Fourteen patients initiated hepatitis C treatment at a Check Hep C site and 6 initiators achieved cure. Conclusion: The community-based model successfully identified persons with HCV infection and linked a large proportion to care. The small number of patients initiating hepatitis C treatment in the program identified the need for patient navigation in high-risk populations. Results can be used to inform screening and linkage-to-care strategies and to support the execution of hepatitis C screening recommendations.
KW - diagnosis
KW - hepatitis C
KW - linkage to care
KW - patient navigation
UR - http://www.scopus.com/inward/record.url?scp=85011277251&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85011277251&partnerID=8YFLogxK
U2 - 10.1097/PHH.0000000000000519
DO - 10.1097/PHH.0000000000000519
M3 - Article
C2 - 28141668
AN - SCOPUS:85011277251
SN - 1078-4659
VL - 24
SP - 41
EP - 48
JO - Journal of Public Health Management and Practice
JF - Journal of Public Health Management and Practice
IS - 1
ER -