Few insured individuals receive timely direct-acting antiviral treatment for hepatitis C

Few insured individuals with hepatitis C virus (HCV) infection receive timely direct-acting antiviral (DAA) treatment, according to research published in the Aug. 9 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

William W. Thompson, Ph.D., from the CDC in Atlanta, and colleagues constructed a cohort of adults aged 18 to 69 years with HCV infection diagnosed during Jan. 20, 2019, and Oct. 31, 2020, to examine initiation of DAA treatment.

The researchers found that the prevalence of DAA treatment initiation within 360 days of the first positive HCV RNA test result was 23, 28, and 35 percent among those with Medicaid, Medicare, and private insurance, respectively; treatment was initiated within 180 days of diagnosis in 75, 77, and 84 percent, respectively, among those treated. Compared with those with private insurance, those with Medicaid and Medicare had lower adjusted odds of treatment initiation (adjusted odds ratios, 0.54 and 0.62, respectively). Treatment initiation was lowest for adults aged 18 to 29 and 30 to 39 years with Medicaid or private insurance versus those aged 50 to 59 years, after adjustment for insurance type. The odds of treatment initiation were lower for persons in states with versus without Medicaid treatment restrictions (adjusted odds ratio, 0.77) and among those whose race was coded as Black or African American or other versus White (adjusted odds ratios, 0.93 and 0.73, respectively).

"Increasing access to hepatitis C treatment to all populations, regardless of insurance type, is essential to reducing viral hepatitis-related disparities and achieving hepatitis C elimination," the authors write.

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