title: Engagement in the Hepatitis C Care Cascade Among Homeless Veterans, 2015.
abstract: The Veterans Health Administration (VHA) is the largest provider of hepatitis C virus (HCV) care nationally and provides health care to >200 000 homeless veterans each year. We used the VHA's Corporate Data Warehouse and HCV Clinical Case Registry to evaluate engagement in the HCV care cascade among homeless and nonhomeless veterans in VHA care in 2015. We estimated that, among 242 740 homeless veterans in care and 5 424 712 nonhomeless veterans in care, 144 964 (13.4%) and 188 156 (3.5%), respectively, had chronic HCV infection. Compared with nonhomeless veterans, homeless veterans were more likely to be diagnosed with chronic HCV infection and linked to HCV care but less likely to have received antiviral therapy despite comparable sustained virologic response rates. Homelessness should not necessarily preclude HCV treatment eligibility with available all-oral antiviral regimens.
authors.affiliation: 1 Department of Internal Medicine, Providence VA Medical Center, Providence, RI, USA.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Noska
authors.affiliation: 2 Patient Care Services/Population Health Services, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Belperio
authors.affiliation: 2 Patient Care Services/Population Health Services, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Loomis
authors.affiliation: 1 Department of Internal Medicine, Providence VA Medical Center, Providence, RI, USA.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: O'Toole
authors.affiliation: 2 Patient Care Services/Population Health Services, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
authors.forename: Lisa I
authors.initials: LI
authors.lastname: Backus
mesh_terms: D000368:Aged; D016208:Databases, Factual; D019698:Hepatitis C, Chronic / Q000453:epidemiology / Q000628:therapy*; D006703:Ill-Housed Persons; D006801:Humans; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans
keywords: hepatitis C; homeless; veterans