title: HCV screening practices and prevalence in an MCO, 2000-2007.
abstract: OBJECTIVE
  The Centers for Disease Control and Prevention recommends routine screening for the hepatitis C virus antibody (anti- HCV) among persons most likely to be infected. Little is known about anti-HCV screening and prevalence in routine practice settings. We studied anti-HCV screening rates, anti-HCV positivity, and demographic and risk factors associated with increased likelihood of anti-HCV screening or positivity in a managed care organization (MCO).
  
  
  METHODS
  This was a retrospective observational study of 17-to-74-year-old MCO enrollees from 2000 to 2007 (N = 557,056; 1,949,499 enrollee years). The primary outcome measures were likelihood of anti-HCV screening and HCV positivity (both in the total population and among those screened). Independent variables were: birth cohort, gender, HCV risk factors, and socioeconomic status (SES) and race of residents' neighborhoods. Likelihood of each outcome as a function of the independent variables was estimated using logistic regression.
  
  
  RESULTS
  Over the 8-year period, 4.31% of the total population received anti-HCV screening; 0.22% had a positive HCV result. Among those screened, HCV positivity was 5.15%. HCV screening and positivity rates increased over time. Both likelihood of HCV screening and HCV positivity were highest (P <0.05) among persons born during 1945-1964, males, those with HCV risk factors, and residents of neighborhoods of lower SES or with higher percentages of African Americans.
  
  
  CONCLUSIONS
  Although HCV screening and detection improved in this MCO over an 8-year period, anti-HCV screening was lower than expected. Many persons at risk for HCV remained unscreened. Strategies for improving anti-HCV screening in routine practice are recommended for patients at increased risk.
authors.affiliation: Kaiser Permanente Georgia, Atlanta, GA 30305, USA. douglas.roblin@kp.org
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Roblin
authors.forename: Bryce D
authors.initials: BD
authors.lastname: Smith
authors.forename: Cindy M
authors.initials: CM
authors.lastname: Weinbaum
authors.forename: Miriam E
authors.initials: ME
authors.lastname: Sabin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D018937:Hepatitis C Antibodies