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Updated: Jun 21, 2025

A Protocol for Analyzing Hepatitis C Virus Replication
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Provider reported implementation barriers to hepatitis C elimination in Washington State.

Paula Cox-North1, Lisa Wiggins2, Jon Stockton3

  • 1Department of Biobehavioral Nursing and Health Informatics, University of Washington, Box 357260, Seattle, Washington, 98195, USA. paulac@uw.edu.

BMC Primary Care
|July 11, 2024
PubMed
Summary

High Hepatitis C (HCV) screening in Washington State contrasts with low treatment rates. Key barriers to HCV treatment include clinician knowledge gaps and insufficient numbers of treating clinicians, hindering elimination goals.

Keywords:
BarriersHepatitis CStigmaSubstance useWashington State

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Area of Science:

  • Hepatology
  • Public Health
  • Infectious Diseases

Background:

  • Hepatitis C (HCV) treatment is available, yet only 12% of diagnosed individuals in Washington State received it in 2018.
  • Washington State initiated an HCV elimination plan in 2019 to improve screening and treatment access.

Purpose of the Study:

  • To identify provider and health system barriers to implementing HCV screening and treatment in Washington State.

Main Methods:

  • A 2022 online survey assessed 547 healthcare providers in Washington State regarding their HCV screening and treatment practices.
  • Eligible providers practiced in primary care, infectious disease, gastroenterology, or community health settings.
  • Survey questions covered screening/treatment practices, barriers, knowledge, stigma, and co-management willingness.

Main Results:

  • HCV screening adoption was high (96%), with few reported barriers.
  • Only 28% of providers treated HCV, with 71% referring patients elsewhere.
  • Barriers to treatment included knowledge deficits (64%) and lack of organizational support (24%).

Conclusions:

  • Despite high screening, significant barriers impede HCV treatment implementation in Washington State.
  • Lack of treating clinicians and clinician knowledge deficits are primary obstacles to HCV treatment.
  • Expanding and educating the HCV-treating clinician workforce is crucial for achieving HCV elimination by 2030.