Despite the dramatic rise in referrals to primary care physicians (PCPs) for people testing positive for hepatitis C virus (HCV), PCPs are apparently much less likely than specialists to get such patients treated for the virus.
Presenting their findings in a poster at the Annual Meeting of the American Association for the Study of Liver Diseases in San Francisco, researchers conducted an analysis of data sets from two large national testing laboratory companies. They analyzed 2013 to 2016 data and defined an HCV antibody test as a screening and a positive follow-up HCV RNA test as a diagnosis.
The study authors followed those diagnosed with hep C over time to see whether they saw an HCV specialist, including a gastroenterologist, hepatologist or infectious disease clinician, or a PCP, and whether they received treatment for the virus.
In 2013, 179,144 people tested positive for HCV antibodies; of those, 45 percent had a follow-up HCV RNA test; 63.8 percent of that group were RNA positive. In 2016, of the 287,130 people who tested positive for HCV antibodies, 76.5 percent were tested for HCV RNA; 63.9 percent of that group were RNA positive.
The proportion of those who saw a specialist declined from 25.4 percent of baby boomers who tested positive for HCV RNA in 2013 to 23.4 percent of baby boomers who tested positive in 2016, while the corresponding proportions those 18 to 39 years old declined from 17.1 percent to 9.2 percent. Meanwhile, the proportion of those who saw a PCP increased from 37.7 percent to 40.9 percent of boomers who tested positive in 2013 and 2016, respectively, and remained steady among young people at about 40 percent between those two years.
Treatment rates rose between 2013 and 2016, with baby boomers (those born between 1945 and 1965) much more likely than those between ages 18 and 39 to receive treatment, whether or not they saw a specialist or a PCP.
In 2013, 10.6 percent of baby boomers and 15.4 percent of those in the younger age bracket who saw a specialist were treated for the virus, compared with a respective 2.9 percent and 4.2 percent of those who saw a PCP. In 2016, 32 percent of baby boomers and 22.6 percent of those in the younger age bracket who saw a specialist were treated for the virus, compared with a respective 8.1 percent and 4.5 percent of those who saw a PCP.