Determinants of hepatitis C virus treatment completion among Los Angeles County residents

Hepatitis C viral infection is curable, yet only about one-third of identified cases have been cleared nationally. We evaluated determinants of treatment completion in a sample of newly reported hepatitis C cases among Los Angeles County residents.

Using information from the Los Angeles County Hepatitis C Case Registry, we contacted reported hepatitis C ribonucleic acid (RNA) positive cases diagnosed from January 2021 through April 2022. We used Pearson's Chi-Square Tests and multivariable logistic regression to identify demographic and clinical characteristics associated with self-reported hepatitis C virus treatment completion.

Among 2,992 reported RNA-positive cases, 619 (21%) were successfully contacted. Among those, most respondents were untreated (72%), male (65%), and tested by primary care providers (50%). Individuals 30-44 years old had 2.9 (95% CI: 1.1, 7.4) times the odds of having completed treatment during initial contact compared to 18-29 year-olds, adjusted for ordering provider type, race/ethnicity, health insurance type, and symptom status. Respondents tested by specialists had 1.8 (95% CI: 1.2, 2.8) times the odds of completing treatment compared to those tested by primary care providers. Respondents who reported symptoms in the past six months had 0.2 (95% CI: 0.1, 0.4) times the odds of completing treatment compared to respondents with no symptoms. Characteristics of respondents were the same as those diagnosed with hepatitis C in Los Angeles County.

We verified low hepatitis C treatment completion at the population-level. Those 18-29 years old and diagnosed in primary care were least likely to complete treatment.