2024-03-182024-03-182022-09-02Nicole D Ferrante, Craig W Newcomb, Kimberly A Forde, Charles E Leonard, Jessie Torgersen, Benjamin P Linas, Sarah E Rowan, David L Wyles, Jay Kostman, Stacey B Trooskin, Vincent Lo Re, The Hepatitis C Care Cascade During the Direct-Acting Antiviral Era in a United States Commercially Insured Population, Open Forum Infectious Diseases, Volume 9, Issue 9, September 2022, ofac445, https://doi.org/10.1093/ofid/ofac4452328-8957http://hdl.handle.net/20.500.12613/9903Background: Periodic surveillance of the hepatitis C virus (HCV) care cascade is important for tracking progress toward HCV elimination goals, identifying gaps in care, and prioritizing resource allocation. In the pre-direct-acting antiviral (DAA) era, it was estimated that 50% of HCV-infected individuals were diagnosed and that 16% had been prescribed interferon-based therapy. Since then, few studies utilizing nationally representative data from the DAA era have been conducted in the United States. Methods: We performed a cross-sectional study to describe the HCV care cascade in the United States using the Optum de-identified Clinformatics® Data Mart Database to identify a nationally representative sample of commercially insured beneficiaries between January 1, 2014 and December 31, 2019. We estimated the number of HCV-viremic individuals in Optum based on national HCV prevalence estimates and determined the proportion who had: (1) recorded diagnosis of HCV infection, (2) recorded HCV diagnosis and underwent HCV RNA testing, (3) DAA treatment dispensed, and (4) assessment for cure. Results: Among 120,311 individuals estimated to have HCV viremia in Optum during the study period, 109,233 (90.8%; 95% CI, 90.6%–91.0%) had a recorded diagnosis of HCV infection, 75,549 (62.8%; 95% CI, 62.5%–63.1%) had a recorded diagnosis of HCV infection and underwent HCV RNA testing, 41,102 (34.2%; 95% CI, 33.9%–34.4%) were dispensed DAA treatment, and 25,760 (21.4%; 95% CI, 21.2%–21.6%) were assessed for cure. Conclusions: Gaps remain between the delivery of HCV-related care and national treatment goals among commercially insured adults. Efforts are needed to increase HCV treatment among people diagnosed with chronic HCV infection to achieve national elimination goals.7 pagesengAttribution-NonCommercial-NoDerivs CC BY-NC-NDhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.enHepatitis C eliminationHIV/HCV coinfectionCascade of careHealth claims databaseHepatitis C monitoringText