Population health tools: How lab data can help manage hepatitis C
By: Robert L Schmidt MD, PhD, MBA, Health Systems Medical Director, Head of Population Informatics, Labcorp
Hepatitis C (Hep C or HCV) is a significant public health concern in the United States, with an estimated 2.4 million people living with the virus.1 Approximately 80% of people with hepatitis C have no symptoms and can live for years without knowing they have it.2 For the remaining 20%, symptoms can include poor appetite, nausea, vomiting and fever.3 As a result, there is no independent indication for a provider to order hepatitis C testing.
What is hepatitis C?
Hepatitis C is a viral infection of the liver. Left untreated, it can cause liver cirrhosis, eventually leading to liver failure. It is estimated that up to 20% of those diagnosed with hepatitis C will develop cirrhosis within the first 20 years of infection.4 Patients with hepatitis C have an estimated 17-fold increased risk of developing liver cancer.5
Hepatitis C can be treated, and even cured, in as little as 8-12 weeks with anti-viral medication. But first, it must be diagnosed. The U.S. Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force (USPSTF) recommend that all adults 18-79 years old get tested at least once to determine whether they have hepatitis C. If diagnosed, people can receive treatment and avoid the serious effects of hepatitis C.
Diagnosing hepatitis C and subsequent care management concerns
Testing is performed in two steps: a screening test and a confirmatory test. The screening test detects hepatitis C antibodies. This test will be positive for anyone infected at some point in their life, but it can’t determine whether a person is currently infected. The confirmatory test, an FDA-approved nucleic acid test (NAT), detects hepatitis C RNA to determine a current infection. The CDC recommends that any person with a positive screening test should have a confirmatory test.
Unfortunately, some people may not receive a confirmatory test after getting a positive screening result. This group has a high probability of having hepatitis C, and those infected are unaware they have the disease. Since it is spread through exposure to contaminated blood or by sharing of contaminated personal items like razors or toothbrushes, undiagnosed hepatitis C can easily be passed to others. Identifying these patients is important so they can be treated and cured.
How lab data can help
So how can providers identify patients in their practice who have had a positive screen but not a confirmation test?
Labcorp’s population health tool, Insight AnalyticsTM, can help. Using the Insight Analytics platform, providers can generate a list of patients missing confirmatory testing. Providers can then contact individual patients to arrange a confirmatory test and follow-up care.
This report is only one piece of Labcorp’s portfolio of hepatitis C diagnostics. Through a comprehensive hepatitis C menu, including options for screening, diagnosis, staging, prognosis and monitoring of patients with hepatitis C, Labcorp is committed to improving outcomes and reducing the spread of this infection.
To request a demo of Insight Analytics, contact us.
1. Hofmeister MG, Rosenthal EM, Barker LK, Rosenberg ES, Barranco MA, Hall EW, Edlin BR, Mermin J, Ward JW, Ryerson AB. Estimating Prevalence of Hepatitis C Virus Infection in the United States, 2013-2016. Hepatology. 2019 Mar;69(3):1020-1031. doi: 10.1002/hep.30297. Epub 2018 Nov 6. PMID: 30398671; PMCID: PMC6719781.
2. Aman W, Mousa S, Shiha G, Mousa SA. Current status and future directions in the management of chronic hepatitis C. Virology Journal. 2012;9:57.
3. World Health Organization. Hepatitis C fact sheet. June 24, 2022. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c#:~:text=Symptoms,do%20not%20exhibit%20any%20symptoms
4. Lingala S, Ghany MG. Natural History of Hepatitis C. Gastroenterol Clin North Am. 2015 Dec;44(4):717-34. doi: 10.1016/j.gtc.2015.07.003. Epub 2015 Aug 25. PMID: 26600216; PMCID: PMC5939344.
5. de Oliveria Andrade LJ, D'Oliveira A, Melo RC, De Souza EC, Costa Silva CA, Paraná R. Association between hepatitis C and hepatocellular carcinoma. J Glob Infect Dis. 2009 Jan;1(1):33-7. doi: 10.4103/0974-777X.52979. PMID: 20300384; PMCID: PMC2840947.