Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United States
Introduction and aim: Real-world epidemiologic data to guide hepatitis C virus (HCV)-related public health initiatives are lacking. The aim of this study was to describe the prevalence and epidemiological characteristics of a large cohort of patients with an HCV diagnosis evaluated in one of the lar...
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doaj-2198969ea5de475fa2749b2b377cca9c2021-06-09T05:50:17ZengElsevierAnnals of Hepatology1665-26812019-03-01182360365Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United StatesNizar A. Mukhtar0Erik M. Ness1Manan Jhaveri2Oren K. Fix3Marquis Hart4Christopher Dale5Cheryl Pratt6Kris V. Kowdley7Liver Care Network and Organ Transplant Program, Swedish Medical Center, Seattle, WA, USA; Providence Health & Services, Renton, WA, USALiver Care Network and Organ Transplant Program, Swedish Medical Center, Seattle, WA, USA; Providence Health & Services, Renton, WA, USALiver Care Network and Organ Transplant Program, Swedish Medical Center, Seattle, WA, USA; Providence Health & Services, Renton, WA, USALiver Care Network and Organ Transplant Program, Swedish Medical Center, Seattle, WA, USA; Providence Health & Services, Renton, WA, USALiver Care Network and Organ Transplant Program, Swedish Medical Center, Seattle, WA, USA; Providence Health & Services, Renton, WA, USALiver Care Network and Organ Transplant Program, Swedish Medical Center, Seattle, WA, USA; Providence Health & Services, Renton, WA, USAProvidence Health & Services, Renton, WA, USALiver Care Network and Organ Transplant Program, Swedish Medical Center, Seattle, WA, USA; Providence Health & Services, Renton, WA, USA; Corresponding author at: Liver Care Network and Organ Care Research, Swedish Medical Center, 1124 Columbia Street, Suite 600, Seattle, WA 98104, USA.Introduction and aim: Real-world epidemiologic data to guide hepatitis C virus (HCV)-related public health initiatives are lacking. The aim of this study was to describe the prevalence and epidemiological characteristics of a large cohort of patients with an HCV diagnosis evaluated in one of the largest health systems in the United States. Materials and methods: De-identified demographic and clinical data were extracted from the electronic health record for patients actively followed within the Providence Health & Services health care system. Rates of HCV prevalence and co-morbid illnesses among HCV-infected patients were determined. Results: Among 2,735,511 active patients, 23,492 (0.86%) were found to have evidence of HCV infection, the majority of which were Caucasian (78.2%) and born between the years 1945 and 1965 (68.3%). In comparison to Caucasians, higher rates of HCV infection were found among Native Americans (2.5% vs. 0.95%, p < 0.001). Compared to HCV-negative patients, a greater proportion of HCV-positive patients had diabetes mellitus (18.7 vs. 8.9%, p < 0.0001), chronic kidney disease (4.4 vs. 1.8%, p < 0.0001), end-stage renal disease necessitating hemodialysis (2.6 vs. 0.6%, p < 0.0001), and HIV co-infection (2.4 vs. 0.2, p < 0.0001). Nearly two-thirds (62.1%) of HCV patients had government-sponsored insurance, and 93.0% of treated patients resided in urban settings. Conclusion: The prevalence of HCV infection in this large health care system serving the Pacific Northwest, Alaska, and California was lower than prior population-based estimates and may reflect real-world prevalence rates among patients not selected for risk-based screening. Native Americans are disproportionately affected by HCV and may warrant targeted screening.http://www.sciencedirect.com/science/article/pii/S1665268119300523HCV epidemiologyViral hepatitisPublic healthPublic policyInfectious diseases |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nizar A. Mukhtar Erik M. Ness Manan Jhaveri Oren K. Fix Marquis Hart Christopher Dale Cheryl Pratt Kris V. Kowdley |
spellingShingle |
Nizar A. Mukhtar Erik M. Ness Manan Jhaveri Oren K. Fix Marquis Hart Christopher Dale Cheryl Pratt Kris V. Kowdley Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United States Annals of Hepatology HCV epidemiology Viral hepatitis Public health Public policy Infectious diseases |
author_facet |
Nizar A. Mukhtar Erik M. Ness Manan Jhaveri Oren K. Fix Marquis Hart Christopher Dale Cheryl Pratt Kris V. Kowdley |
author_sort |
Nizar A. Mukhtar |
title |
Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United States |
title_short |
Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United States |
title_full |
Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United States |
title_fullStr |
Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United States |
title_full_unstemmed |
Epidemiologic features of a large hepatitis C cohort evaluated in a major health system in the western United States |
title_sort |
epidemiologic features of a large hepatitis c cohort evaluated in a major health system in the western united states |
publisher |
Elsevier |
series |
Annals of Hepatology |
issn |
1665-2681 |
publishDate |
2019-03-01 |
description |
Introduction and aim: Real-world epidemiologic data to guide hepatitis C virus (HCV)-related public health initiatives are lacking. The aim of this study was to describe the prevalence and epidemiological characteristics of a large cohort of patients with an HCV diagnosis evaluated in one of the largest health systems in the United States. Materials and methods: De-identified demographic and clinical data were extracted from the electronic health record for patients actively followed within the Providence Health & Services health care system. Rates of HCV prevalence and co-morbid illnesses among HCV-infected patients were determined. Results: Among 2,735,511 active patients, 23,492 (0.86%) were found to have evidence of HCV infection, the majority of which were Caucasian (78.2%) and born between the years 1945 and 1965 (68.3%). In comparison to Caucasians, higher rates of HCV infection were found among Native Americans (2.5% vs. 0.95%, p < 0.001). Compared to HCV-negative patients, a greater proportion of HCV-positive patients had diabetes mellitus (18.7 vs. 8.9%, p < 0.0001), chronic kidney disease (4.4 vs. 1.8%, p < 0.0001), end-stage renal disease necessitating hemodialysis (2.6 vs. 0.6%, p < 0.0001), and HIV co-infection (2.4 vs. 0.2, p < 0.0001). Nearly two-thirds (62.1%) of HCV patients had government-sponsored insurance, and 93.0% of treated patients resided in urban settings. Conclusion: The prevalence of HCV infection in this large health care system serving the Pacific Northwest, Alaska, and California was lower than prior population-based estimates and may reflect real-world prevalence rates among patients not selected for risk-based screening. Native Americans are disproportionately affected by HCV and may warrant targeted screening. |
topic |
HCV epidemiology Viral hepatitis Public health Public policy Infectious diseases |
url |
http://www.sciencedirect.com/science/article/pii/S1665268119300523 |
work_keys_str_mv |
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