Methods: A retrospective validation study of the use of genotype testing as a marker for linkage to care was performed at Bellevue Hospital Center (BHC): a large urban public hospital. The medical charts of all 487 patients who had a positive HCV antibody test at our institution between January 2014 to February 2015 were retrospectively reviewed.
Seventy-nine charts were excluded because their RNA testing was negative signifying either cleared infection or previous curative treatment. A total of 408 charts were then evaluated to determine if a genotype test was performed during the study period and whether this patient attended an appointment with an HCV treating provider at BHC within four months of HCV antibody testing.
Results: 130 patients had a genotype performed at BHC during the study period. Of those, 93 (72%) were linked to care and 37 (28%) were not. Of 278 patients without a genotype, 15 (5%) were linked to care and 263 (95%) were not. The sensitivity of the genotype as a proxy for linkage to care was 86% (CI: 78% - 92%) and a specificity of 88% (CI: 83% - 91%). The positive predictive value was 72% (CI: 63% - 79%) and the negative predictive value was 95% (CI: 91% - 97%). The odds of being linked to care for those with a genotype performed was 41.1 compared to those without a genotype test (CI: 21.9 - 77.5, p-value: <0.0001).
Conclusion: The lack of a reported HCV genotype strongly correlates with not being linked to care with an HCV treating provider at BHC. The NYCDOMH will continue to evaluate the usefulness of genotype results as a proxy for linkage to care. This information can be used to develop targeted interventions to monitor and increase linkage to care, treatment and cure.
F. Laraque, None
K. Bornschlegel, None
E. Mcgibbon, None
H. Horowitz, None
E. Carmody, None