SECAUCUS, N.J., May 11, 2021 /PRNewswire/ -- A new Quest
Diagnostics Health Trends® report developed in
collaboration with the Centers for Disease Control and Prevention
(CDC) found that the COVID-19 pandemic reduced routine hepatitis C
virus (HCV) testing and treatment. The study was published online
today in American Journal of Preventative Medicine.
The study builds on an ongoing collaboration between Quest and
CDC to study viral hepatitis infections and support the goal to
eliminate hepatitis C in the United
States. It is also the first large scale study by Quest
Diagnostics to analyze patterns in hepatitis C virus antibody
screening and RNA diagnostic testing along with prescription
treatments, providing insights into the interplay of laboratory
testing and therapy.
The study underscores that people living with undiagnosed
hepatitis C could develop more advanced disease prior to eventually
confirming their infection status, including cirrhosis and liver
cancers, leading to higher rates of morbidity and death. Further,
people living with undiagnosed HCV infections may continue to
unknowingly transmit the virus to others. According to CDC, people
with chronic hepatitis C can often have no symptoms and don't feel
sick. When symptoms appear, they often are a sign of advanced liver
disease.
According to the findings:
- HCV antibody testing (used to screen for potential active HCV
infection) volume decreased 59% during the early stage of the
COVID-19 pandemic (April 2020) and
rebounded to a 6% reduction in July, compared with the same months
in 2018 and 2019
- The number of HCV RNA (used to diagnose active HCV infection)
positive results fell by 62% in March
2020 and remained 39% below the same months in 2018 and
2019
- For hepatitis C treatment, prescriptions decreased 43% in May,
37% in June, and 38% in July of 2020, relative to the corresponding
months in 2018 and 2019
- Although HCV antibody screening rebounded close to the 2019
(pre-pandemic) volume, in June and July
2020, HCV RNA confirmed positives (diagnoses) and HCV
treatments remained nearly 40% below the corresponding months of
2019
"This analysis adds to other studies that demonstrate that lack
of access to testing and care in 2020 during the height of the
pandemic means many individuals did not receive important
diagnostic test and screenings, said Harvey
W. Kaufman, M.D., Senior Medical Director, Head of the
Health Trends Research Program for Quest Diagnostics, and the
report's lead author. "It's important we communicate the need to
bring Hepatitis C virus testing and treatment above pre-pandemic
levels to identify people who have delayed or skipped healthcare
services. Fortunately, HCV infection is now a curable condition and
taking an HCV antibody screening test is the first step."
About HCV Prevalence; Gaps in Care and Testing
Recommendations
HCV infection is the most commonly reported
bloodborne infection in the U.S. and is a leading cause of
liver-related morbidity and mortality.1,2 An estimated
2.4 million adults in the U.S. are living with HCV infection.
Hepatitis C was reported as the underlying or contributing cause
for 15,713 deaths in 2018.1 Approximately 70% of adults
with acute HCV infection develop chronic HCV infection. If
untreated, 1 in 4 of these individuals will die prematurely from
HCV-associated complications such as liver failure and
hepatocellular carcinoma.2 During 2015–2018, only 61% of
people diagnosed with hepatitis C were aware they were living with
hepatitis C infection, suggesting a gap in care.3
In response to increasing rates of acute HCV infection among
young adults, including reproductive-aged people, the U.S.
Preventive Services Task Force recommends laboratory screening for
HCV in adults, aged 18–79 years as well as women during
pregnancy.4 The CDC also recommends hepatitis C testing
at least once per lifetime for all adults aged 18 years and over,
and for all pregnant women during each pregnancy.5
Study Methodology
This study represents the largest
analysis of its kind to date, assessing the impact of the COVID-19
pandemic on HCV testing and treatment. Investigators evaluated data
from a large national reference clinical laboratory and national
estimates of dispensed prescriptions for HCV treatment. The
analysis included 12,309,475 HCV antibody test results and 326,603
HCV RNA test results during the time period from 2018 through
2020. In addition, the investigators analyzed 486,181
hepatitis C direct acting antiretroviral (DAA) medications
dispensed January 2018 through
July 2020 based on new and refilled
pharmacy transactions in a national prescription database.
Investigators from Quest Diagnostics and the CDC evaluated the
average number of HCV antibody tests, HCV antibody positive test
results, and HCV RNA positive test results by month, January
through July 2020, compared to the
same months in 2018 and 2019. To assess the impact of HCV
treatment, dispensed HCV direct acting antiretroviral
medications were examined for the same time periods.
For the full study methodology, please see
https://www.ajpmonline.org/article/S0749-3797(21)00220-8/fulltext.
About Quest Diagnostics Health Trends™
Quest
Diagnostics Health Trends™ is a series of scientific reports that
provide insights into health topics, based on analysis of objective
clinical laboratory data, to empower better patient care,
population health management and public health policy. The reports
are based on the Quest Diagnostics database of 48 billion
de-identified laboratory test results, believed to be the largest
of its kind in healthcare. Health Trends has yielded novel insights
to aid the management of allergies and asthma, prescription drug
monitoring, diabetes, Lyme disease, heart disease, influenza and
workplace wellness. Quest Diagnostics also produces the Drug
Testing Index (DTI)™, a series of reports on national workplace
drug positivity trends based on the company's employer workplace
drug testing data. www.QuestDiagnostics.com/HealthTrends
About Quest Diagnostics
Quest Diagnostics empowers
people to take action to improve health outcomes. Derived from the
world's largest database of clinical lab results, our diagnostic
insights reveal new avenues to identify and treat disease, inspire
healthy behaviors and improve healthcare management. Quest annually
serves one in three adult Americans and half the physicians and
hospitals in the United States, and our 50,000 employees understand
that, in the right hands and with the right context, our diagnostic
insights can inspire actions that transform
lives. www.QuestDiagnostics.com
REFERENCES
- Viral hepatitis surveillance—United States, 2018. Atlanta, GA: HHS, CDC; 2020.
https://www.cdc.gov/hepatitis/statistics/2018surveillance/index.htm.
Accessed March 30, 2021.
- Seo S, Silverberg MJ, Hurley LB, et al. Prevalence of
spontaneous clearance of hepatitis C virus infection doubled from
1998 to 2017. J Clin Gastroenterol Hepatol.
2020;18(2):511‒513. https://doi.org/10.1016/j.cgh.2019.04.035.
- Ryerson AB, Schillie S, Barker LK, Kupronis BA, Wester C. Vital
signs: newly reported acute and chronic hepatitis C cases —
United States, 2009–2018. MMWR
Morb Mortal Wkly Rep. 2020;69(14):399‒404.
https://doi.org/10.15585/mmwr.mm6914a2.
- U.S. Preventative Services Task Force. Hepatitis C virus
infection in adolescents and adults: screening: United States
Preventative Services Task Force statement. JAMA.
2020;323(10):970‒975. https://doi.org/10.1001/jama.2020.1123.
- Schillie S, Wester C, Osborne M, Wesolowski L, Ryerson AB. CDC
recommendations for hepatitis C screening among adults —
United States, 2020. MMWR
Recomm Rep. 2020;69(RR-2):1–17.
https://doi.org/10.15585/mmwr.rr6902a1.
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