Abstract
In the United States hepatitis C virus (HCV) is a leading cause of liver disease, liver cancer and infectious disease-related death equal to or surpassing HIV infection. Approximately 20% of those with chronic, untreated HCV infection will develop cirrhosis and eventually liver failure, or liver cancer. Highly effective, and safe treatment with 8-12 weeks of antiviral medications cures the infection and prevents complications.
Our preliminary data show that there is a major gap between knowing the result and starting treatment in Los Angeles County. Among 403 cases contacted, 227 (56%) had public insurance, 254 (63%) were male, 230 (57%) were 45+ years old, and 181 (45%) were Hispanic or Latino. Of those, 85% were aware of their infection but only about one-third were treated. Reasons for not starting treatment included inadequate insurance coverage, limited access to specialized physicians, and competing life priorities.
We are proposing a pilot study to develop and evaluate a new linkage to a treatment program that utilizes active patient navigation for residents of LA County. We will expand our existing collaboration with the LA Department of Public Health using the county HCV case registry to identify untreated cases of HCV. We will contact and educate cases and link them to medical treatment. We aim to collect initial data (RFA Goal A) and identify ways to improve access to care through population-tailored interventions (RFA Goal B).
This is a new collaboration between the KSOM Department of Population and Public Health Sciences and the Sol School of Public Policy offering opportunities for public health practice and policy development and evaluation. Findings from this proposal will support a large-scale NIH R01 implementation science application to the NIH on accelerating hepatitis C elimination.