465. Referral and Treatment Patterns of Hepatitis C
Session: Poster Abstract Session: Prevention and Treatment of Viral Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • HepC.jpg (378.9 kB)
  • Background: Hepatitis C virus (HCV) infection is a common blood-borne disease in the United States; approximately 3.2 million people are infected chronically. Prompt evaluation for possible treatment is important to avoid complications of HCV infection.

    Methods: This was a retrospective cross-sectional study at an academic primary care practice. The objectives were to describe referral and treatment patterns of HCV infection and identify patient characteristics associated with delay in HCV care. HCV-infected patients were identified based on ICD-9 billing codes. Exclusion criteria included missing electronic medical records and patients followed by a HCV specialist prior to their initial presentation to our practice. Patient characteristics associated with delay in HCV care were determined using time-to-event methods. Differences were evaluated using Kaplan-Meier plots and log-rank tests.  

    Results: Two hundred and thirty five patients were included, of which 215 were referred to a HCV specialist. Mean age was 50 years. Sixty four percent were male and fifty six percent were white. Median duration from HCV diagnosis to referral to HCV specialist was 411 days. Median duration from referral to HCV specialist visit was 71 days. Thirty two percent of 215 patients who were referred did not have a documented specialist visit. Only twenty six patients (11%) were started on HCV treatment and the median duration from referral to initiation of treatment was 226 days. Primary care providers or HCV specialists’ reasons for no referral and no HCV treatment, respectively, included patient preference, substance abuse, psychiatric disorders, lost to follow-up and others.  Patient characteristics associated with an earlier assessment of Hepatitis C included marital status, HIV co-infection and history of any medical co-morbidity.

    Conclusion: Most HCV- infected patients were referred to a HCV specialist. However, HCV treatment was infrequent with a prolonged duration from time of diagnosis to treatment. Patient, physician and system factors need to be addressed to improve care.

    Wei Boon Ooi, MD1, Fernando Madero-Gorostieta, MD1, Saurabh Dahiya, MD2, Michael Rosenblum, MD1, Alexander Knee3, Armando Paez, MD4 and Daniel Skiest, MD4, (1)Internal Medicine, Baystate Medical Center, Springfield, MA, (2)Neuro Oncology, Cleveland Clinic, Cleveland, OH, (3)Epidemiology and Biostatistics, Baystate Medical Center, Springfield, MA, (4)Infectious Diseases, Baystate Medical Center, Springfield, MA


    W. B. Ooi, None

    F. Madero-Gorostieta, None

    S. Dahiya, None

    M. Rosenblum, None

    A. Knee, None

    A. Paez, None

    D. Skiest, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.