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. 2021 Sep;61(3):369-376.
doi: 10.1016/j.amepre.2021.03.011. Epub 2021 May 10.

Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic

Harvey W Kaufman  1 , Lara Bull-Otterson  2 , William A Meyer 3rd  3 , Xiaohua Huang  3 , Mona Doshani  4 , William W Thompson  4 , Ademola Osinubi  4 , Mohammed A Khan  4 , Aaron M Harris  4 , Neil Gupta  4 , Michelle Van Handel  4 , Carolyn Wester  4 , Jonathan Mermin  4 , Noele P Nelson  4
Affiliations

Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic

Harvey W Kaufman et al. Am J Prev Med. 2021 Sep.

Abstract

Introduction: The COVID-19 pandemic has disrupted healthcare services, reducing opportunities to conduct routine hepatitis C virus antibody screening, clinical care, and treatment. Therefore, people living with undiagnosed hepatitis C virus during the pandemic may later become identified at more advanced stages of the disease, leading to higher morbidity and mortality rates. Further, unidentified hepatitis C virus-infected individuals may continue to unknowingly transmit the virus to others.

Methods: To assess the impact of the COVID-19 pandemic, data were evaluated from a large national reference clinical laboratory and from national estimates of dispensed prescriptions for hepatitis C virus treatment. Investigators estimated the average number of hepatitis C virus antibody tests, hepatitis C virus antibody-positive test results, and hepatitis C virus RNA-positive test results by month in January-July for 2018 and 2019, compared with the same months in 2020. To assess the impact of hepatitis C virus treatment, dispensed hepatitis C virus direct-acting antiretroviral medications were examined for the same time periods. Statistical analyses of trends were performed using negative binomial models.

Results: Compared with the 2018 and 2019 months, hepatitis C virus antibody testing volume decreased 59% during April 2020 and rebounded to a 6% reduction in July 2020. The number of hepatitis C virus RNA-positive results fell by 62% in March 2020 and remained 39% below the baseline by July 2020. For hepatitis C virus treatment, prescriptions decreased 43% in May, 37% in June, and 38% in July relative to the corresponding months in 2018 and 2019.

Conclusions: During the COVID-19 pandemic, continued public health messaging, interventions and outreach programs to restore hepatitis C virus testing and treatment to prepandemic levels, and maintenance of public health efforts to eliminate hepatitis C infections remain important.

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Figures

Figure 1
Figure 1
HCV antibody test volume, 2018 through 2020, by MMWR week. Note: Sporadic dips reflect national holiday weeks. The MMWR week is the week of the epidemiologic year for which the NNDSS disease report is assigned by the reporting local or state health department for the purposes of MMWR disease incidence reporting and publishing. Values for MMWR week range from 1 to 53, although most years consist of 52 weeks. HCV, Hepatitis C virus; MMWR, Morbidity and Mortality Weekly Report; NNDSS, National Notifiable Diseases Surveillance System.
Figure 2
Figure 2
Monthly change in HCV RNA–positive test results and HCV treatment prescriptions in 2020 versus a combined 2018 and 2019 baseline. Note: Gray bars represent percent change in HCV RNA–positive test results in 2020 versus a combined 2018 and 2019 baseline. Black line represents percent change in HCV treatment prescriptions in 2020 versus a combined 2018 and 2019 baseline. HCV, Hepatitis C virus.
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