Report highlights critical actions needed to monitor HCV epidemic

Routine testing for hepatitis C virus (HCV) infection-still not part conducted by many providers-is critical to reduce the prevalence and eliminate the disease, according to a new report.

“The disease is symptomatic in most people, even while the virus is doing damage to a person's liver, so most patients will not have reason to seek treatment. There is an effective, curative drug treatment, direct-acting antivirals, available that is highly tolerated by most, unlike HCV treatments of the past. There is no reason for patients to suffer the health consequences of a prolonged infection anymore,” report co-author Sonia Canzater, JD, MPH, associate at the O’Neill Institute for National and Global Health Law at Georgetown University told Medical Economics.

The report was published on June 14.

The HCV report draws on insights from thought leaders, administrators and healthcare practitioners to identify capacity and needs related to data on the HCV epidemic. It identifies five critical actions that should be priorities for monitoring HCV:

·       Expand and standardize reporting to the Centers for Disease Control and Prevention

·       Utilize electronic health records to collect data on HCV cases and the cure cascade

·       Fund epidemiologic research using clinical data sets

·       Integrate improved monitoring of HCV with responses to the opioid epidemic

·       Establish and monitor HCV elimination plans across major U.S. health systems

Next: Missed opportunities from a lack of integration

Canzater sees a lack of integration between healthcare systems and sharing of data.

There is a missed opportunity for local and state health departments, healthcare providers, laboratories and health insurers to utilize centralized record keeping systems. These systems “allow them all to input data on patients, and develop reports and analyze data on the number of cases of HCV, demographic information on identified cases, access to follow-up care to treat a discovered infection​, and other beneficial surveillance data that could be sourced from this central repository,” she said.

Canzater added that HCV case reports are often inconsistent or missing useful information needed to develop a clearer understanding of risk factors and how to focus prevention and treatment efforts.

Only 14 states have the fiscal or personnel resources to conduct active surveillance of the disease, including health department staff following up with providers to collect all diagnosed cases, and collecting other statistically useful information that was not included in the initial reports in order to create a more accurate picture of the impact of the disease.

She noted that HCV alone was responsible for nearly half of the 23,000 liver cancer deaths that occurred in 2012, based on the most current statistics. “This is due to untreated chronic infections that caused significant liver damage and ultimately led to cancer. An increase in early diagnosis and treatment of HCV infections would allow very few HCV infections to progress to have such an adverse effect on a person's health,” said Canzater. 

Primary care physicians should become familiar with the risk factors associated with HCV, identify patients who should be tested, advise them to do so and tell them why they may be at greater risk, she said.