Targeted Testing Effectively Identifies Baby Boomers with HCV

Implementing birth cohort (BC) testing strategies effectively increases the likelihood of identifying baby boomers with hepatitis C (HCV), according to a recent study.

The Centers for Disease Control and Prevention and the United States Preventive Services Task Force recommend testing individuals born from 1945 through 1965 for hepatitis C (HCV). To determine the effects of BC testing on rates of HCV diagnosis in primary care, researchers conducted 3 independently designed randomized controlled trials at 3 academic medical centers from December 2012 to March 2014.
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All 3 studies included patients born during 1945 through 1965 with no clinical documentation of previous HCV testing or diagnosis. Patients were randomly assigned to receive 1-time HCV testing through 1 of 3 independent implementation strategies or usual care. The trial interventions included repeated-mailing outreach, EMR-integrated provider best practice alert (BPA), or direct patient-solicitation. In addition, the researchers estimated model-adjusted risk ratios for anti-HCV positive identification using BC testing compared with usual care.

In the mailing trial, 2993 patients were assigned to the intervention and 5,999 were assigned to receive usual care. Overall, the mailing intervention was 8 times more likely to identify patients with HCV compared with usual care. 

The BPA intervention trial included 8928 patients assigned to the intervention and 5547 assigned to usual care. BPA was 2.6 times more likely to identify patients with HCV compared with usual care.

The patient-solicitation trial included 4307 patients assigned to the intervention and 4566 assigned to usual care. Patient-solicitation was 5 times more likely to identify patients with HCV compared with usual care.

“BC testing was effective in identifying previously undiagnosed HCV infections in primary care settings,” the researchers concluded.

—Melissa Weiss

Reference:

Yartel AK, Rein DB, Ann Brown K, et al. Hepatitis C virus testing for case identification in persons born during 1945-1965: results from three randomized controlled trials [published online September 23, 2017]. Hepatology. doi:10.1002/hep.29548.