HCV screening practices and prevalence in an MCO, 2000-2007

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Services Research

Background:

• The Centers for Disease Control and Prevention recommends routine hepatitis C virus antibody (anti-HCV) screening for high-risk populations.
• Limited data exist on anti-HCV screening practices and prevalence within routine managed care settings.
• This study investigated anti-HCV screening rates and positivity within a large managed care organization (MCO).

Purpose of the Study:

• To determine anti-HCV screening rates and positivity among MCO enrollees.
• To identify demographic and risk factors associated with anti-HCV screening and positivity.
• To evaluate trends in screening and positivity over an 8-year period.

Main Methods:

• A retrospective observational study analyzed data from 557,056 MCO enrollees aged 17-74 from 2000-2007.
• Logistic regression was used to estimate the likelihood of anti-HCV screening and HCV positivity.
• Independent variables included birth cohort, gender, HCV risk factors, and neighborhood socioeconomic status (SES) and race.

Main Results:

• Over 8 years, 4.31% of the total population were screened for anti-HCV, with a 5.15% positivity rate among those screened.
• Screening and positivity rates increased over time.
• Higher likelihood of screening and positivity were observed in individuals born 1945-1964, males, those with HCV risk factors, and residents of lower SES or predominantly African American neighborhoods.

Conclusions:

• Anti-HCV screening and detection improved within the MCO but remained lower than anticipated.
• A significant proportion of individuals at risk for HCV were not screened.
• Enhanced strategies are recommended to improve anti-HCV screening for at-risk populations in routine practice.