The U.S. health care system is apparently failing to keep people diagnosed with hepatitis C virus (HCV) in medical care, and ultimately to treat them for the virus. Publishing their findings in the journal Hepatology, researchers culled information from the Philadelphia Department of Public Health’s hepatitis surveillance data, covering January 2010 through December 2013, in order to analyze how well people identified as HCV positive made it through the various steps in what is known as the “care continuum.”

“The inadequacy of screening programs has made it difficult for state health departments to accurately determine the extent of HCV and the rate of transmission within the community,” Kendra Viner, PhD, MPH, from the Philadelphia Department of Public Health, who is the study’s lead author, said in a press release. “Our study examines the management of HCV care at a population level to determine which patients tend to fall out of the medical system and why this might occur.”

The researchers calculated population estimates based on 2010 U.S. Census data, on the National Health and Nutrition Examination Survey (NHANES) data, as well as on population figures gathered about groups at high risk for hep C that NHANES did not cover, including the homeless and incarcerated people.

An estimated 2.9 percent of the 1.58 million Philadelphians are estimated to have hep C. During the study period, the health department received notice that 13,596 people in the city had tested positive for the virus. Just 1,745 (27 percent) of these individuals were in care, and 956 (15 percent) had been treated or were being treated.

“Our findings show that many HCV patients are lost at each stage of the health care continuum from screening to disease confirmation to care and treatment,” Viner concluded in the press release. “The fact that so few patients with HCV are making it to treatment underscores the need to build awareness among at-risk groups of the importance of screening and continued care. It is critical that public health officials and clinicians understand why patients are lost at each stage so that changes can be made to improve care for those with chronic HCV.”

To read the study abstract, click here.

To read the press release, click here.