Hepatitis C Virus Infection Screening Within Community Health Centers

Context: Approximately 2.7 million people in the United States currently live with chronic hepatitis C virus (HCV) infection, and many are unaware that they have the disease. Community health centers (CHCs) serve as the primary care safety net for more than 22 million patients who are at risk for health inequities and represent an important frontline resource for early screening and treatment for HCV infection. Objective: To understand HCV infection screening rates among CHC patients, and to quantify the screening gap by demographic characteristics. Methods: The authors analyzed a deidentified dataset obtained through electronic health records from a large national network of CHCs. All adults at risk for HCV infection, according to the US Preventive Services Task Force (USPSTF) birth cohort screening guidelines for HCV infection, were considered eligible if they had a patient office visit between January 1, 2013, and December 31, 2013. Data were reviewed to determine the documentation of HCV infection screening from January 1, 2010, to December 31, 2013, and HCV infection screening rates were analyzed by age, race/ethnicity, and sex. Results: Among 60,722 eligible patients, 5033 (8.3%) had an HCV infection screen in accordance with USPSTF birth cohort screening guidelines. Women were less likely to be screened than men in every race/ethnic group, including white Hispanic (9.3% in women vs 5.4% in men), black Hispanic (15.1% in women vs 9.0% in men), white non-Hispanic (13.6% in women vs 8.1% in men), black non-Hispanic (14.9% in women vs 8.9% in men), Caribbean Islander or Haitian (6.5% in women vs 3.7% in men), and other races/ethnicities (6.3% in women vs 3.6% in men). Conclusion: To the authors knowledge, this is the first large-scale study among CHCs to assess the screening gap of the USPSTF birth cohort screening guidelines for HCV infection. This study suggests that CHCs should consider opportunities to improve HCV infection screening, thereby contributing to the reduction of health inequities resulting from untreated HCV infection.