Quest Diagnostics announced a new Health Trends report developed in collaboration with the Centers for Disease Control and Prevention (CDC), which found that the COVID-19 pandemic reduced routine hepatitis C virus (HCV) testing and treatment.
The study, published online in American Journal of Preventative Medicine, 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
Harvey W. Kaufman, M.D., Senior Medical Director, Head of the Health Trends Research Program for Quest Diagnostics, and the report's lead author, said, "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."
HCV infection is the most commonly reported bloodborne infection in the U.S. and is a leading cause of liver-related morbidity and mortality. 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. Approximately 70% of adults with acute HCV infection develop chronic HCV infection. If untreated, one in four of these individuals will die prematurely from HCV-associated complications such as liver failure and hepatocellular carcinoma. During 2015 to 2018, only 61% of people diagnosed with hepatitis C were aware they were living with hepatitis C infection, suggesting a gap in care.
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 to 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.
