HCV Testing Uptake “Limited” Even Among Baby Boomers

Only one in six baby boomers report having been tested for hepatitis C virus (HCV)< despite recommendations for universal screening, according to a brief report published in the April issue of Clinical Infectious Diseases. Further, sociodemographic disparities further hamper HCV testing both among baby boomers and younger adults.

HCV is a public health concern, given both increasing incidence of infection among young people injecting drugs as part of the opioid crisis and increasing HCV-related morbidity and mortality among persons born between 1945 and 1965, who have had “clinically silent” infections and have remained undiagnosed for years.

Previous studies have shown that in order to reach national goals for reducing HCV incidence and HCV-related mortality, an estimated 70,000 to 110,000 new cases will need to be diagnosed each year until 2030.

In the present study, researchers used data from the National Health Interview Survey (2013 to 2017) to identify adults born between 1945 and 1994. Participants were asked, “Have you ever had a blood test for hepatitis C?” Responses were analyzed for participants answering either yes or no (n = 120 539).marginally

The researchers found that HCV testing coverage increased between 2013 and 2017 both among respondents born between 1966 and 1994 (13.2 percent to 16.8 percent) and respondents born between 1945 and 1965 (12.3 percent to 17.3 percent). Despite statistically significant increases, the authors classified these changes as only marginal. There were no increases in HCV testing over time among respondents without health insurance in any age group. HCV testing coverage was lower than for either hepatitis B virus and HIV testing among all age groups.

Among baby boomers, HCV testing coverage was significantly lower among females, individuals with less than a high school education, and foreign-born persons. Testing coverage was highest in the West. Further, those with military health insurance and public or government health insurance had higher HCV testing coverage than baby boomers with private health insurance.

“In addition to interventions to improve HCV screening in traditional health care settings, integrating HCV testing programs into nontraditional settings (e.g., nursing homes, emergency departments, and methadone clinics) and implementing community-based programs may be key strategies to expand coverage of HCV testing,” write the authors led by Eshan Patel, from Johns Hopkins University in Baltimore, Md.

Takeaway: Rates of HCV testing remain low even among baby boomers, a cohort for whom universal testing is recommended. Rates are even lower for some sociodemographic subsets of age-based cohorts.