Cargando…

Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor

BACKGROUND: Chronic hepatitis C (HCV) infection affects over 2.4 million Americans and accounts for 18 000 deaths per year. Treatment initiation in this population continues to be low even after introduction of highly effective and shorter duration direct-acting antivirals. This study assesses facto...

Descripción completa

Detalles Bibliográficos
Autores principales: Lin, Janet, Mauntel-Medici, Cammeo, Maheswaran, Anjana Bairavi, Baghikar, Sara, Pugach, Oksana, Stein, Ellen M, Martin, Michelle T, Nguyen, Hai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8904194/
https://www.ncbi.nlm.nih.gov/pubmed/33539524
http://dx.doi.org/10.1093/pubmed/fdaa276
_version_ 1784664904139014144
author Lin, Janet
Mauntel-Medici, Cammeo
Maheswaran, Anjana Bairavi
Baghikar, Sara
Pugach, Oksana
Stein, Ellen M
Martin, Michelle T
Nguyen, Hai
author_facet Lin, Janet
Mauntel-Medici, Cammeo
Maheswaran, Anjana Bairavi
Baghikar, Sara
Pugach, Oksana
Stein, Ellen M
Martin, Michelle T
Nguyen, Hai
author_sort Lin, Janet
collection PubMed
description BACKGROUND: Chronic hepatitis C (HCV) infection affects over 2.4 million Americans and accounts for 18 000 deaths per year. Treatment initiation in this population continues to be low even after introduction of highly effective and shorter duration direct-acting antivirals. This study assesses factors that influence key milestones in the HCV care continuum. METHODS: Retrospective time-to-event analyses were performed to assess factors influencing liver fibrosis staging and treatment initiation among individuals confirmed with chronic HCV infection at University of Illinois Hospital and Health Sciences System between 1 August 2015 and 24 October 2016 and followed through 28 January 2018. Cox regression models were utilized for multivariable analyses. RESULTS: Individuals tested at the liver clinic (hazard ratio [HR] = 2.03; 95% confidence interval [CI]: 1.19–3.46) and at the federally qualified health center (HR = 3.51; 95% CI: 2.19–5.64) had higher instantaneous probability of being staged compared with individuals tested at the emergency department (ED) or inpatient setting. And probability of treatment initiation increased with advancing liver fibrosis especially for Medicaid beneficiaries (HR = 1.64; 95% CI: 1.35–1.99). CONCLUSIONS: The study demonstrates a need for improving access for patients with early stages of the disease in order to reduce HCV-related morbidity and mortality, especially those tested at nontraditional care locations such as the ED or the inpatient setting.
format Online
Article
Text
id pubmed-8904194
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-89041942022-03-09 Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor Lin, Janet Mauntel-Medici, Cammeo Maheswaran, Anjana Bairavi Baghikar, Sara Pugach, Oksana Stein, Ellen M Martin, Michelle T Nguyen, Hai J Public Health (Oxf) Original Article BACKGROUND: Chronic hepatitis C (HCV) infection affects over 2.4 million Americans and accounts for 18 000 deaths per year. Treatment initiation in this population continues to be low even after introduction of highly effective and shorter duration direct-acting antivirals. This study assesses factors that influence key milestones in the HCV care continuum. METHODS: Retrospective time-to-event analyses were performed to assess factors influencing liver fibrosis staging and treatment initiation among individuals confirmed with chronic HCV infection at University of Illinois Hospital and Health Sciences System between 1 August 2015 and 24 October 2016 and followed through 28 January 2018. Cox regression models were utilized for multivariable analyses. RESULTS: Individuals tested at the liver clinic (hazard ratio [HR] = 2.03; 95% confidence interval [CI]: 1.19–3.46) and at the federally qualified health center (HR = 3.51; 95% CI: 2.19–5.64) had higher instantaneous probability of being staged compared with individuals tested at the emergency department (ED) or inpatient setting. And probability of treatment initiation increased with advancing liver fibrosis especially for Medicaid beneficiaries (HR = 1.64; 95% CI: 1.35–1.99). CONCLUSIONS: The study demonstrates a need for improving access for patients with early stages of the disease in order to reduce HCV-related morbidity and mortality, especially those tested at nontraditional care locations such as the ED or the inpatient setting. Oxford University Press 2021-02-05 /pmc/articles/PMC8904194/ /pubmed/33539524 http://dx.doi.org/10.1093/pubmed/fdaa276 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Lin, Janet
Mauntel-Medici, Cammeo
Maheswaran, Anjana Bairavi
Baghikar, Sara
Pugach, Oksana
Stein, Ellen M
Martin, Michelle T
Nguyen, Hai
Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor
title Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor
title_full Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor
title_fullStr Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor
title_full_unstemmed Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor
title_short Factors predicting staging and treatment initiation for patients with chronic hepatitis C infection: insurance a key predictor
title_sort factors predicting staging and treatment initiation for patients with chronic hepatitis c infection: insurance a key predictor
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8904194/
https://www.ncbi.nlm.nih.gov/pubmed/33539524
http://dx.doi.org/10.1093/pubmed/fdaa276
work_keys_str_mv AT linjanet factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor
AT mauntelmedicicammeo factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor
AT maheswarananjanabairavi factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor
AT baghikarsara factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor
AT pugachoksana factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor
AT steinellenm factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor
AT martinmichellet factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor
AT nguyenhai factorspredictingstagingandtreatmentinitiationforpatientswithchronichepatitiscinfectioninsuranceakeypredictor