No Differences in Achieving Hepatitis C Virus Care Milestones Between Patients Identified by Birth Cohort or Risk-Based Screening.
National hepatitis C virus (HCV) screening guidelines recommended 1-time testing of persons born between 1945 and 1965.



We performed a retrospective study to compare care milestones achieved by HCV-infected patients identified by birth cohort versus risk-based screens.



We determined the proportions of patients newly identified with HCV infection who met care milestones (viral load, referral to and evaluation by a specialist, offer of treatment, initiation of treatment, and sustained viral response) and the time it took to reach them. We found no differences in HCV care milestones for patients identified via birth cohort testing versus risk-based screening. Overall, only 43% of HCV antibody-positive patients were referred to care, and less than 4% started treatment. The time to each care milestone was lengthy and varied greatly; treatment was initiated in a median of 308 days.



Although birth cohort testing will likely increase identification of patients with HCV infection, it does not seem to increase the number of patients that meet management milestones. New methods are needed to increase access to care and establish efficient models of health care delivery.
Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York; Division of General Internal Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York. Electronic address: bnorton@montefiore.org.
Brianna L
BL
Norton
Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York; Division of Hospital Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
William N
WN
Southern
Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York; Division of General Internal Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Meredith
M
Steinman
Division of Viral Hepatitis, Centers for Disease Control and Prevention, National Center for HIV/Viral Hepatitis/STD/TB Prevention, Atlanta, Georgia.
Bryce D
BD
Smith
Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York; Division of General Internal Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Joseph
J
Deluca
Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York; Division of General Internal Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Zachary
Z
Rosner
Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York; Division of General Internal Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Alain H
AH
Litwin
D000328:Adult; D000368:Aged; D019468:Disease Management; D005260:Female; D006302:Health Services Research; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies
Antiviral Agent; Cascade of Care; Patient Management; Population; Therapy