1040. Hepatitis C Surveillance Markers Study: A Validation of Genotype as a Laboratory Proxy for Linkage to Care
Session: Poster Abstract Session: Hepatitis Viruses
Friday, October 9, 2015
Room: Poster Hall
Posters
  • HCV Surveillance Marker Study - _Final draft.pdf (493.2 kB)
  • Background: 3.5 million Americans and 146,500 New York City residents have chronic hepatitis C virus (HCV).  The New York City Department of Health and Mental Hygiene (NYCDOMH) is committed to using surveillance data to improve the HCV cascade of care from diagnosis through cure. After screening for HCV infection, linkage to care is an important step in the care cascade that needs to be monitored and improved. Positive HCV antibody, HCV RNA and HCV genotype are all reportable to the NYCDOHMH. We hypothesized that an HCV genotype might be a laboratory proxy for linkage to care and that the lack of a genotype signifies not being in HCV care.

    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.

    Jason Halperin, MD, MPH1, Asher Schranz, MD2, Fabienne Laraque, MD, MPH3, Katherine Bornschlegel, MPH4, Emily Mcgibbon, MPH5, Harold Horowitz, MD6 and Ellie Carmody, MD1, (1)Division of Infectious Diseases and Immunology, New York University, New York, NY, (2)Internal Medicine, New York University, New York, NY, (3)Viral Hepatitis Surveillance, Prevention and Control Program, New York City Department of Health & Mental Hygiene, New York, NY, (4)Bureau of Communicable Diseases, New York City Department of Health and Mental Hygiene, Long Island City, NY, (5)Bureau of Communicable Diseases, NYC Department of Health and Mental Hygiene, New York, NY, (6)Infectious Diseases, New York University School of Medicine, New York, NY

    Disclosures:

    J. Halperin, None

    A. Schranz, None

    F. Laraque, None

    K. Bornschlegel, None

    E. Mcgibbon, None

    H. Horowitz, None

    E. Carmody, None

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