Hepatitis C Antibody Testing in a Commercially Insured Population, 2005-2014.
BACKGROUND
In the U.S., the burden of hepatitis C virus (HCV) infection and associated sequelae is substantial. HCV prevalence is highest among those born in 1945-1965 (Birth Cohort). Newly diagnosed infections are increasing in younger people concurrent with rising opioid/heroin use. The Centers for Disease Control and Prevention (2012) and U.S. Preventive Services Task Force (2013) recommend HCV testing for at-risk individuals and one-time testing for the Birth Cohort. This study describes national trends in HCV antibody testing from 2005 to 2014.


METHODS
Using commercial and Medicare supplemental insurance claims data, people were identified who were continuously enrolled for ≥2 years during the 10-year study period, without prior HCV diagnosis (N=190,926,299). Current Procedural Terminology codes identified 3,382,267 unique antibody tests. Temporal trends in annual testing were evaluated using the Cochran-Armitage test, and primary ICD-9-CM diagnosis codes used at the time of testing were described. Data were analyzed in 2015 and 2016.


RESULTS
Testing was highest among those aged 18-29 and 30-39 years, increasing by 123% (1.66% to 3.71%) and 108% (1.99% to 4.13%), respectively (p<0.0001). Among the Birth Cohort, there was a 136% increase in HCV antibody testing from 2005 to 2014, with a 91% increase from 1.71% in 2011 to 3.26% 2014 (p<0.0001).


CONCLUSIONS
Although the increased HCV antibody testing observed among the Birth Cohort from 2011 to 2014 likely reflects early adoption of updated national testing recommendations, overall testing remains low in this commercially insured population, indicating a clear need for improvement.
Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: xwz0@cdc.gov.
Cheryl J
CJ
Isenhour
Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
Susan H
SH
Hariri
Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
Craig M
CM
Hales
Prevention Branch, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.
Claudia J
CJ
Vellozzi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000032:analysis / Q000276:immunology*; D006801:Humans; D007345:Insurance Claim Review; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D006278:Medicare / Q000191:economics*; D008875:Middle Aged; D015995:Prevalence; D058996:Quality Improvement; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D018937:Hepatitis C Antibodies